The viability of hemodialysis as a treatment option for renal failure in a developing economy

The viability of hemodialysis as a treatment option for renal failure in a developing economy like Nigeria was assessed in this study to determine whether committing huge capital in establishing such centres all over the country is justifiable. A total of 158 patients dialysed at the Owena Dialysis Centre over a period of 3 years (January 1991-December 1993) were studied. There were 112 males and 46 females, ranging in age between 15 and 81 years. 17 of patients had acute renal failure (ARF), while 141 had chronic renal failure (CRF). During the period of study, a total of 1,452 dialysis sessions were carried out ranging between 8 and 77 sessions per month (mean 40 sessions/month). Dialysis sessions ranged between 1 and 101 sessions per patient. A progressive increase in the number of dialysis sessions between 1991 and 1993 was noted, and new patients who required dialysis were being seen at a rate of between 1 and 10 per month. 112 patients (70.8%) could afford dialysis for less than one month while only 3 (1.9%) could afford to continue dialysis for over 12 months. All cases of ARF (except one) recovered normal renal function after dialysis, while 116 CRF patients were discharged home after less than 10 sessions of dialysis due to financial constraints. The study shows that hemodialysis is a relevant treatment option for renal failure even in a developing economy like Nigeria subject to adequate health planning. The major limitations to its profitable utilization under the present health care dispensations are highlighted.