Renal Replacement Therapy Resources in Africa

Abstract

Background: Africa is the world’s second-largest and most-populous continent. It is also the world’s poorest inhabited continent. Regarding chronic kidney disease (CKD), there are no reliable statistics in most African countries. However, there is a general impression that it is at least three to four times more frequent than in more developed countries Methods: a survey on renal replacement therapy in Africa was conducted in the context of the African Association of Nephrology (AFRAN) Congress 2007. A questionnaire was sent to leading African nephrologists, and data were also collected from the main dialysis supply companies and by personal communication. Data have been obtained from 32 out of 54 countries, representing 89% of the total population. Results: There are no reliable statistics regarding CKD in most African countries. The total number of nephrologists in the continent is 1154 (1-4 pmp). The total number of patients on hemodialysis (HD) is just over 60000 patients (<50 pmp in many countries). Peritoneal dialysis (PD) is only available in 12 African countries, and the total number of PD patients is around 2000. Renal
transplantation is performed in 10 of the 53 countries, and only five countries have sustained programs that perform more than 50 cases per year. Conclusion: CKD is an under-recognized health challenge in Africa. Research should be encouraged to gauge the exact incidence and prevalence of CKD in African countries and define its regional risk factors. Efforts are needed to train physicians in this specialty, and strategies for judicious resources allocation should be implemented.

Key words: renal replacement therapy, chronic kidney disease, dialysis, transplantation, Africa