Patient-Related Factors Influencing Kidney Transplantation Uptake among Hemodialysis Patients in Gaborone, Botswana
DOI:
https://doi.org/10.70619/vol6iss4pp31-41776Keywords:
Kidney transplantation, hemodialysis, patient factors, uptake, Botswana.Abstract
Chronic kidney disease (CKD) is a growing public health burden globally, with a disproportionately high impact in low- and middle-income countries such as Botswana. Although hemodialysis (HD) remains the most widely used renal replacement therapy, kidney transplantation (KT) is the preferred treatment option due to improved survival, better quality of life, and long-term cost-effectiveness. Despite Botswana’s subsidized renal services, KT uptake among HD patients remains low. This study examined patient factors as determinants of KT uptake among HD patients in Gaborone, Botswana. An analytical cross-sectional study was conducted among 163 adult HD patients proportionally sampled from three dialysis centres in Gaborone. Data were collected using structured questionnaires that captured socio-demographic characteristics and patient-related factors, including knowledge, attitudes, comorbidities, and perceptions of KT. Descriptive statistics were used to summarize participant characteristics, while chi-square tests were applied to identify patient-level predictors of KT uptake. Only 17.2% of participants had initiated the KT process, indicating low uptake. Bivariate analysis showed significant associations between KT uptake and selected patient demographic factors, particularly age, gender, and education level. However, most patient-related attributes, including knowledge, attitudes, comorbidities, and cultural or religious beliefs, were not significantly associated with KT uptake. The most commonly reported patient-related barriers were a lack of a suitable donor and inadequate information, suggesting that perceived donor limitations remain a key challenge for patients. Kidney transplantation uptake among HD patients in Gaborone remains low despite the availability of subsidized services. Findings suggest that while demographic characteristics such as age influence uptake, most patient-related factors play a limited role, with donor-related constraints emerging as the dominant barrier from the patient perspective. Strengthening patient counseling, improving access to transplant information, and supporting family-based donor engagement may improve transplantation uptake.
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