Lived Experiences of Patients with End-Stage Renal Disease (ESRD) on Maintenance Hemodialysis at Machakos County, Kenya

End-Stage Renal Disease (ESRD) is the final stage of chronic kidney disease that requires lifelong renal replacement therapy such as hemodialysis or kidney transplantation for survival. Despite the increasing burden of ESRD in Kenya, little is known about the lived experiences of patients undergoing maintenance hemodialysis, particularly in low-resource settings. This study explored the lived experiences of patients with ESRD receiving maintenance hemodialysis at Machakos County Referral Hospital, Kenya, with an emphasis on changes in daily routines and coping mechanisms resulting from hemodialysis. The study adopted a descriptive phenomenological qualitative research design. Sixteen patients who had been on maintenance hemodialysis for at least one year were purposively selected. Data were collected through semi-structured in-depth interviews conducted in English and Kiswahili. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed using Braun and Clarke’s six-phase framework with support from ATLAS.ti version 8.4.4. Findings revealed that maintenance hemodialysis significantly affected patients' physical, psychological, social, and economic well-being. Five major themes emerged: seriousness of the disease, challenges of accessing hemodialysis, financial constraints, restricted life, and psychological impacts. Participants reported high treatment and transport costs, fatigue, dietary and fluid restrictions, disruption of social and work life, machine breakdowns, anxiety, depression, altered body image, and dependence on dialysis machines and family support. Religious faith and family support emerged as the main coping mechanisms among participants. The study concludes that ESRD and maintenance hemodialysis pose profound, multidimensional challenges for patients and their families. The study recommends expanding health insurance coverage for dialysis-related costs, establishing satellite dialysis centers in rural areas, integrating psychosocial support into renal care, strengthening community-based kidney disease awareness programs, and forming patient support groups to improve the quality of life for patients on maintenance hemodialysis.