Delivery of kidney care in Africa is significantly constrained by various factors. In this review, we used International Society of Nephrology–Global Kidney Health Atlas (ISN–GKHA) data for Africa to address sub-regional differences in care delivery in the continent with focus on infrastructure, workforce, and the economic aspects of kidney care. Forty two African countries participated in the survey conducted in 2018. North Africa had the highest proportions of nephrologists [12.53 per million population (pmp)], nephrology trainees (2.19 pmp) and haemodialysis (HD) centres (8.58 pmp); whereas southern Africa had the highest proportions of peritoneal dialysis (PD) centres (0.89 pmp) and kidney transplant (KT) centres (0.29 pmp); West Africa had the greatest nephrology workforce shortages. The annual median costs of HD (US$22,731 [interquartile range (IQR): US$1,560–43,902]) and PD (US$34,165 [US$34,165–34,165]) were highest in Central Africa and only Algeria, Egypt and South Africa reported zero co-payment for all modalities of kidney replacement therapy in the public sector. Policies on chronic kidney disease and non-communicable diseases were scarcely available across all African sub-regions. The ISN–GKHA African data highlight a stark difference in kidney care measures between North and sub-Saharan Africa and also suggest the need for a more cohesive approach to policy formulations that support and protect patients with kidney disease in the continent, especially from the excessive costs associated with care. Using the World Health Organization (WHO) Global Action Plan for noncommunicable diseases, this paper proposes an African roadmap for optimal kidney care. Keywords: CKD, kidney failure, dialysis, transplantation, cost, policy
Background: Kidney failure known as renal failure or Stage 5 CKD or End Stage Renal Diseases is a major problem among kidney diseases worldwide, its incidence and prevalence are rising yearly. The management requires renal replacement therapy, hemodialysis, 3 sessions per week or peritoneal dialysis until the time of renal transplantation. The cost is high in low income countries and is not covered by major medical insurances. Few renal patients are able to afford dialysis and renal transplantation. Case Presentation: A 45-year-old man Butcher, living in rural Rwanda presented with renal failure and Hypertension with history of native medication intake. He remained on chronic maintenance hemodialysis since October 2017, at one to two hemodialysis sessions per month. He preserved quality of life and cognitive function. He is reporting to have more than 1000 cc of urine volume per day. Conclusion: This case demonstrates that suboptimal hemodialysis sessions can help the renal patients to survive when they preserve residual renal functions.
Conclusions: Universal precautions are standard for dialysis units, including hand washing, gloves, masks and aprons. On the 27 th March 2020 South Africa went into hard lockdown due to an emerging coronavirus epidemic. Lockdown improved compliance and contributed to containment. Symptom based testing would have missed 7 early cases of infection, potentially exposing staff and other patients to mortal harm. Monthly screening would have allowed us to detect the two patients who became seriously ill in August earlier. Vulnerability seems to be increased by shared public transport. Crowding at hospital entrances may reasonably create opportunities for spread.As we anticipate a second wave, it is imperative that universal testing of all who access healthcare facilities be implemented. The role of antibody testing in this regard remains to be elucidated. Social issues governing exposure are a more difficult long-term challenge.
in 52.8%. ARI on admission was found in 81.1%. 35.8% of patients underwent dialysis on admission and 41,5% pregressed to terminal stage of chronic kidney disease.The mean proteinuria was 3.11g / 24h +/-2.79 with extremes of 2.19 and 2.97g / 24h. nophrotic syndrom was present in 22,6% of patiens. Renal biopsy was performed in 23 cases It showed myeloma cast nephropathy in 14 patients, AL amyloidosis in 9 patients, a case of membranoproliferative glomerulonephritis (MPGN) and a case of membranous nephropathy (MN).The majority of patients received a chemotheray (80,8%), only 7 patients had a graft of hematopoietic stem cells .26,4% of cases showed a favorable renal evolution and 73,6% had a bad evolution of renal function. The mean of overal survival was 17,97. The major cause of death was infectious complications and progression of the disease. Conclusions: Renal impairement in MM is a commen complication that worsen the prognosis of the disease.Treating early and efficacy with new chemotheray drugs can stop or delay the progression and improve survival outcomes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.