What is Chronic kidney Disease CKD

It is an increasingly life threatening, underappreciated disease around the globe. Symptoms of CKD are non-specific and manifest late, so diagnosis of the disease is easily missed. Once the kidneys have failed, the only option available to the patient is either dialysis or transplantation.

Africa has the lowest dialysis uptake rates in the world despite being one of the most common disease compared to the developed world. Dialysis outcomes are strongly reliant on the quality, duration and frequency of dialysis and other ancillary treatments.

Research studies from BMC Nephrology, conducted at University of Dodoma, Tanzania and another article from ResearchGate, where Nigeria was a reference point have suggested that millions of people die from CKD as a result of the following:

Financial Obstacles

Cost of dialysis treatment poses serious financial challenges for the patient and their families. In most parts of Africa, there are no reimbursements or government subsidies for dialysis. This has led to patient paying for the treatment out of their own pocket. Majority of population in Africa are on low to medium income and sustaining the haemodialysis maintenance treatment presents a huge challenge for the population. Standard haemodialysis is prescribed three times weekly for 4-5 hours per session. Majority of the population are only able to afford for up to twice a weeks or bare minimum once a week. Unsustainability of haemodialysis contributes to high mortality rates in patients.

Illiteracy

Importance of educating patient on the life style measures, adherence of treatment upon feeling well, well balanced dietary requirements and maintenance of interval between treatments.

Inadequate Dialysis Infrastructure

Dialysis infrastructure is scarcely available in most part of Africa because majority of the population with CKD are based in the rural areas and they need to travel long distances to be able to access the facilities available in their country. This adds extra financial burden and time for a patient and their families.

Secondly, many centres are equipped with old refurbished units with no available spare parts and very little technical back up resulting in frequent breakdown of these units. This constraint is further complicated with power fluctuation in the country and many units are largely dependent on generators and this further increases the running cost which is bared by the patients.

Shortage of Trained Nephrology and Allied Personnel

Treatment of Dialysis is reliant on the trained healthcare personnel’s. Shortage of specialist care due to relocation outside of the continent for better prospects has been one of the major contributor of poor outcome of patients.

Conclusion

Many constraints and challenges Africa has to overcome to reduce the mortality rate of haemodialysis patients. The most important are the cost of the treatment, Health education, Compliance of treatment and inadequate infrastructure. Increased financial commitment/subsidies on the part of the governments are essential in achieving the overall long term success not only of improving access to dialysis treatment but also funding research and training to retain the healthcare personnel in the region.