Socio-Ecological Analysis of the Factors Contributing to Delayed Presentation of Patients with Chronic Kidney Disease

Background Chronic kidney disease (CKD) is a progressive condition with a high global burden, particularly in low- and middle-income countries like India. Despite advancements in medical care, the delayed presentation of patients with CKD remains a critical issue, especially in South India. Understanding the factors influencing this delay is essential for early diagnosis and improving outcomes. Materials and Methods A facility-based convergent parallel mixed-methods study was conducted in a tertiary care institution in Andhra Pradesh. The quantitative component involved 200 CKD patients who completed an 18-item awareness questionnaire. For qualitative analysis, 30 patients participated in focus group discussions (FGDs) to explore individual, interpersonal, institutional, and societal barriers contributing to delayed presentation. Quantitative data were analyzed using descriptive statistics and chi-square tests, while qualitative data were thematically analyzed within the socio-ecological model (SEM) framework. Results Quantitative analysis revealed that 58% of participants presented late, with lower awareness of disease prognosis, medication, and management compared to those who presented early ( p <0.05). Qualitative findings identified several individual factors contributing to delayed presentation, including low health literacy, non-adherence to prescribed medications, and reliance on alternative therapies. Additionally, inadequate family support, deficiencies in healthcare infrastructure, and challenges in physician-patient communication emerged as significant barriers to timely medical consultation. Conclusion The study identified multiple socio-ecological factors contributing to delayed CKD presentation, with a need for targeted interventions addressing patient education, family involvement, and healthcare access. Improved communication between healthcare providers and patients, alongside public health strategies to increase CKD awareness, may help mitigate delays and improve outcomes for CKD patients.