Health Needs in Chronic Kidney Disease on Dialysis: a Qualitative Systematic Review

Abstract

Chronic kidney disease (CKD) by 2017 affected 14.5% of the population in the USA; health needs are defined as “capacity to benefit” and incorporate determinants of health, knowing this is an important opportunity to generate a current and evidence-based picture of current deficiencies that really affect the patient’s health status. This study aims to identify health needs present in patients with CKD on dialysis from the experiences and perspectives of patients, family caregivers, and health professionals. We considered studies in hemodialysis or dialysis peritoneal contexts; disabilities, immigrants, and kidney transplant were excluded. The protocol was registered in PROSPERO; a comprehensive search was performed in MEDLINE, Embase, Web of Science, Lilacs, PsycARTICLES, Sociology Database, Nursing & Allied Health Database (via ProQuest), and gray literature; selection and data extraction were performed by two independent reviewers. Meta-aggregation was used to data analysis and methodological quality assessed. A total of 6818 records were screened and 14 included; a total of 18 categories were produced describing difficulties patients face; six synthesized findings were produced identifying health needs related to facilities and environment during dialysis, care, and relationships with health professionals; to the patient’s life as family and couple and daily activities; and to social conditions as work and social life. These results are a starting point based on evidence for health team and decision-makers have a global look about the impact of the CKD to promote a continuous construction in the care with quality and safety determining key aspects that can be intervened in the short, medium, and long term.