Perceptions of chronic kidney disease among at-risk adults in rural Guatemala

ABSTRACT

This qualitative study explores perceptions of chronic kidney disease (CKD) among adults with abnormal estimated glomerular filtration rate (eGFR) in Guatemala, where the burden of CKD is rising. Qualitative semi-structured interviews were conducted with 39 individuals screened for CKD and found to have abnormal eGFR (defined as <90 mL/min/1.73 m², per Kidney Disease Improving Global Outcomes [KDIGO] guidelines). Interviews occurred in participants’ homes in Spanish or Kaqchikel Mayan. Interview notes were coded for dominant themes through an inductive approach. Interviewees had limited awareness of diabetes and hypertension as CKD risk factors, but appreciated the progressive nature of the disease. While most reported willingness to pursue renal replacement therapies, if necessary, they anticipated economic and geographic barriers. Public health interventions should focus on the association between diabetes, hypertension, and CKD. Improvement of primary care and screening infrastructure is imperative in CKD prevention in low- and middle-income countries (LMICs).

KEYWORDS:

• Chronic kidney disease
• Guatemala
• qualitative research
• non-communicable diseases
• diabetes

Acknowledgements

The authors thank Merida Coj Sajvin, Glenda Gomez, Leah Shaw, Eloin Dhaenens, Magda Sotz Mux, Yoli Raquec, Hector Gomez, and Alvaro Sir for assistance with data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The interview guide, results reporting script, coded data, and elucidated themes that support findings for this study are openly available through Dataverse at the following link: https://doi.org/10.7910/DVN/RFWLMU

Additional information

Funding

This work was funded by the National Institutes of Health [1R21TW010831-01]. MN received support from the Watson Institute for International and Public Affairs Field Research Grant and the Framework in Global Health Program Summer Scholarship at Brown University.