An overview of renal replacement therapy and health care personnel deficiencies in sub-Saharan Africa

Abstract

Summary Chronic kidney disease (CKD) is a public health problem in sub‐Saharan Africa (SSA) but there is limited data to guide programs or plan interventions. To help set priorities and understand the needs for renal replacement therapy a baseline assessment is required. World Health Organization (WHO) databases and Medline were searched to determine the number of physicians, nephrologists, and dialysis centers and patients in SSA. Data on renal transplant (RTx) programs were collected from the WHO Global Observatory on Donation & Transplantation database for deceased‐donor and living‐donor RTx. Of the 47 countries in SSA only 15 had recent data with most rates of physicians per 10 000 population under 2.0. Nigeria and South Africa had the greatest absolute numbers of physicians and nephrologists but Mauritius had the greatest proportion to population. South Africa had the most dialysis patients. Kenya, Nigeria and South Africa were the only countries with RTx programs and reported rates per million population of 0.60, 0.23 and 5.12, respectively. Treatment for patients with CKD in SSA is limited by a lack of physicians, nephrologists, and dialysis centers. Few countries are performing RTx. Resources are needed to increase the health workforce and increase RTx programs in SSA.

Challenges of hemodialysis in a new renal care center: call for sustainability and improved outcome

“…Nigeria has the third highest number (6.3 per million population) of patients on hemodialysis after South Africa and Kenya. 10 Recently, there has been a proliferation of dialysis centers in Nigeria, owned by both private individuals and the government.…”

Global Dialysis Perspective: Mauritius

“…Although it is true that Mauritius has far more nephrologists per million population (npmp) than the countries in sub-Saharan Africa, previous published figures of 10 npmp in 2012 and 8 npmp in 2015 are clear overestimates (12,13,14). The actual figure for 2020 is 7.5 npmp and was far lower previously (see Figure 2).…”

Can we still ignore renal replacement therapy in sub-Saharan Africa? All living beings are created equal

“…El Matri et al demonstrated in 2008 that renal transplantation is performed in 10 of the 53 countries, and only 5 countries (Egypt, South Africa, Tunisia, Algeria, and Sudan) have sustained programs that perform more than 50 cases per year [10]. In 2012, Pozo et al demonstrated that in the 47 sub-Saharan African countries, Kenya, Nigeria, and South Africa were the only countries with renal transplantation programs and reported rates per million population of 0.60, 0.23, and 5.12, respectively [11], Table 2.…”