Meeting Report
End-stage renal disease in Sub-Saharan Africa

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The increasing burden of chronic kidney disease and end-stage renal disease presents a challenge for both developed and emerging countries. While infections remain the leading cause of death in Sub-Saharan Africa (SSA), non-communicable diseases are coming to the forefront. There is a continuing ‘brain drain’ of health-care workers (physicians and nurses) from Africa to more affluent regions. There are no or few nephrologists in many parts of SSA. Chronic kidney disease (CKD) affects mainly young adults aged 20–50 years in Sub-Saharan Africa (SSA) and is primarily due to hypertension and glomerular diseases. HIV-related CKD is assuming increasing prominence and often presents late in end-stage renal disease (ESRD), requiring dialysis. Diabetes mellitus affects 9.4 million people in Africa. The prevalence of diabetic nephropathy is estimated to be 6–16% in SSA. The current dialysis treatment rate is <20 per million population (pmp) (and nil in many countries) in SSA, with in-center hemodialysis being the modality of renal replacement therapy for the majority. Transplantation is carried out in a few SSA countries: South Africa, Sudan, Nigeria, Mauritius, Kenya, Ghana, and Rwanda. Prevention programs are in their infancy in most of SSA, due to lack of personnel and resources. CKD care is especially challenging in SSA, with large numbers of ESRD patients, inadequate facilities and funding, and lack of national or regional registries.

Keywords

chronic kidney disease
end-stage renal disease
renal replacement therapy
Sub-Saharan Africa

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SN received lecture fees from Roche. The author declared no competing interests.