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June 3, 2026Journal of Renal Care0 citationsOpen Access

From Impact to Meaning Reconstruction: A Qualitative Study of the Illness Trajectory in Chronic Kidney Disease Without Kidney Replacement Therapy

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JHJiaojiao HuSZShengcai ZHUKMKunqi MA

Key Points

  • The study aims to explore the lived experiences of patients with non-dialysis chronic kidney disease to identify psychological challenges and management strategies.
  • Interview-based qualitative study with 13 purposive participants from Shenzhen, China.
  • Data collected through in-depth, semi-structured interviews analyzed by content analysis.
  • Framework guided by the Illness Trajectory Framework.
  • Three themes identified: Cognitive and Emotional Impact, Dilemmas in Disease Management, and Adaptation and Meaning Reconstruction.
  • The analysis highlights the dynamic nature of the illness trajectory in chronic kidney disease.
  • Supports the need for phase-specific strategies to enhance patient care and outcomes.

Abstract

BACKGROUND: Living with non-dialysis chronic kidney disease is a complex experience that extends beyond clinical markers. While the physical aspects of the disease are well-documented, a deeper understanding of the patient's subjective journey is needed to inform person-centered care. OBJECTIVE: This study aimed to develop a conceptual understanding of the lived trajectory of patients with non-dialysis chronic kidney disease to identify specific psychological shifts and management challenges. DESIGN: This is an interview-based qualitative study. PARTICIPANTS: A purposive sample of 13 patients with non-dialysis chronic kidney disease was recruited from a tertiary hospital in Shenzhen, China. APPROACH: Data were collected using in-depth, semi-structured interviews and were analyzed using content analysis, guided by the Illness Trajectory Framework. FINDINGS: The analysis generated three central themes that defined the patient's illness trajectory: (1) Cognitive and Emotional Impact, an initial phase characterized by confusion, negative emotions, and identity conflict following diagnosis; (2) Dilemmas in Disease Management, a protracted period of struggle with treatment adherence, conflicting medical advice, and a lack of support; and (3) Adaptation and Meaning Reconstruction, an emergent phase wherein patients began to accept their condition and rebuild a purposeful life. CONCLUSION: The illness experience in non-dialysis chronic kidney disease is a dynamic trajectory composed of distinct, identifiable phases. The resulting three-phase framework offers a valuable conceptual tool for practitioners to better anticipate and address the evolving psychosocial and practical needs of their patients. Implementing phase-specific support strategies is critical for improving patient adaptation and long-term outcomes.

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Cite This Study

Hu et al. (2026) studied this question.

synapsesocial.com/papers/6a1fc5b7dee9eb8c0dce71d3https://doi.org/10.1111/jorc.70064
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