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“I Try Not to Even Think About My Health Going Bad”: a Qualitative Study of Chronic Kidney Disease Knowledge and Coping Among a Group of Urban African-American Patients with CKD

Journal of Racial and Ethnic Health Disparities volume 6, pages 625–634 (2019)Cite this article

Abstract

Context

African-Americans with chronic kidney disease (CKD) are more likely to progress to end-stage renal disease (ESRD). However, African-Americans are less likely to receive care to delay progression of their CKD and to prepare for ESRD treatment.

Objective

The objectives of the study are to understand knowledge among urban, African-American patients diagnosed with CKD and to discover ways they managed their illness and prepared for kidney disease progression.

Design

A qualitative study was conducted using structured interviews. Thematic analysis was used for data interpretation. All 23 participants identified as African-American and had CKD but had not yet reached ESRD requiring renal replacement therapy (RRT). Over half of the participants were women (57%), and the mean age was 53 years old.

Results

Three themes emerged from the data. African-Americans often did not know the severity of their CKD. They struggled to complete all of the diet, exercise, and medication tasks recommended to manage their health conditions, including CKD. Finally, participants, even those with stage 5 CKD, viewed progression to RRT in the next 12 months as unlikely.

Conclusion

African-Americans face many barriers to CKD self-care and preparation for ESRD. Improving outcomes requires clinicians to help patients understand the severity of their CKD, to make informed choices about their care, all the while motivating patients to take actions to prevent CKD progression.

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Funding

This work was funded by the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK K23 DK103111). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, and approval of the manuscript.

Author information

Affiliations

  1. General Internal Medicine, University of Chicago Medicine, 5841 So. Maryland Ave, MC 2007, Chicago, IL, USA

    Lydia Lissanu, Fanny Lopez, Erik Almazan, Gabrielle Metoyer, Michael Quinn, Monica E. Peek & Milda R. Saunders

  2. Nephrology, University of Chicago Medicine, Chicago, IL, USA

    Akilah King

  3. Hospital Medicine, University of Chicago Medicine, Chicago, IL, USA

    Eric Robinson

Authors
  1. Lydia Lissanu
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  2. Fanny Lopez
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  3. Akilah King
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  4. Eric Robinson
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  5. Erik Almazan
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  6. Gabrielle Metoyer
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  7. Michael Quinn
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  8. Monica E. Peek
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  9. Milda R. Saunders
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Corresponding author

Correspondence to Milda R. Saunders.

Ethics declarations

This project was approved by the Institutional Review Board.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Lissanu, L., Lopez, F., King, A. et al. “I Try Not to Even Think About My Health Going Bad”: a Qualitative Study of Chronic Kidney Disease Knowledge and Coping Among a Group of Urban African-American Patients with CKD. J. Racial and Ethnic Health Disparities 6, 625–634 (2019). https://doi.org/10.1007/s40615-019-00561-4

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  • DOI: https://doi.org/10.1007/s40615-019-00561-4

Keywords

  • Chronic kidney disease
  • Qualitative research
  • African-American