A atenção à insuficiência renal no Uruguai: A perspectiva de indivíduos com transplante renal

Abstract

This study examines renal care from the perspective of kidney transplant patients with chronic kidney disease (CKD), as well as their families. A qualitative study was performed in three cities of Uruguay. Using theoretical sampling, we selected 25 persons with CKD that were living with kidney transplants, in addition to five family members. Semi-structured interviews were held to explore the participants’ perspectives, as well as content analysis. Four thematic lines were constructed from the participants’ discourse: recognizing the successes of the system of care, the right to health, identifying problems in care, and formulating proposals for action. The system of care is rated as adequate, efficient, and high-quality by individuals living with kidney transplants who are young, employed, residing in the national capital of Montevideo, and covered by the private health sector. The opposite is true for retirees and pensioners, those with multiple morbidities, from inland Uruguay, covered by the public sector, and living in poverty. The participants also formulated proposals to solve the problems that were identified. In addition to acknowledging free and universal access to renal therapies to which patients feel they have the right, we conclude that kidney transplant patients assess the healthcare favorably and the agencies involved. Nevertheless, there are serious obstacles to accessing free, timely, and high-quality care. We recommend promoting strategies to incorporate proposals by patients and their families in order to improve such care and decrease social inequalities.