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Renal failure in Nigerian children: factors limiting access to dialysis
1Pediatric Nephrology and Hypertension Unit, Obafemi Awolowo University, Teaching Hospitals Complex, P.M.B. 5538, Ile-Ife, Osun State, Nigeria. yetundeolowu@yahoo.com
Insights
Access to dialysis treatment for Nigerian children with renal failure (RF) is severely limited by financial and equipment issues. Preventive nephrology is crucial to reduce RF-related deaths in this population.
Area of Science:
- Pediatric Nephrology
- Public Health
Background:
- Renal failure (RF) poses a significant health challenge in Nigerian children.
- Limited access to renal replacement therapy, such as dialysis, contributes to high morbidity and mortality rates.
Purpose of the Study:
- To investigate factors hindering dialysis access for pediatric RF patients in Nigeria.
- To identify strategies for improving dialysis accessibility and outcomes.
Main Methods:
- A 5-year clinical and laboratory study involving 81 pediatric RF patients.
- Analysis of eligibility for dialysis, financial capacity, and actual dialysis utilization.
- Identification of barriers including financial constraints, equipment failure, and personnel shortages.
Main Results:
- Only 10.90% of eligible pediatric RF patients received dialysis.
- Financial restrictions (33%) and lack of dialysis equipment (45%) were primary barriers.
- Undialyzed patients experienced significantly higher mortality rates compared to dialyzed or non-dialysis-dependent RF patients.
Conclusions:
- Significant barriers prevent adequate dialysis access for Nigerian children with RF.
- Preventive nephrology strategies are essential to mitigate RF burden from preventable causes.
- Improving infrastructure, funding, and parental consent are vital for enhancing dialysis access.
Abstract:
A 5-year clinical and laboratory study of Nigerian children with renal failure (RF) was performed to determine the factors that limited their access to dialysis treatment and what could be done to improve access. There were 48 boys and 33 girls (aged 20 days to 15 years). Of 81 RF patients, 55 were eligible for dialysis; 33 indicated ability to afford dialysis, but only 6 were dialyzed, thus giving a dialysis access rate of 10.90% (6/55). Ability to bear dialysis cost/dialysis accessibility ratio was 5.5:1 (33/6). Factors that limited access to dialysis treatment in our patients included financial restrictions from parents (33%), no parental consent for dialysis (6%), lack or failure of dialysis equipment (45%), shortage of dialysis personnel (6%), reluctance of renal staff to dialyze (6%), and late presentation in hospital (4%). More deaths were recorded among undialyzed than dialyzed patients ( P<0.01); similarly, undialyzed patients had more deaths compared with RF patients who required no dialysis ( P<0.025). Since most of our patients could not be dialyzed owing to a range of factors, preventive nephrology is advocated to reduce the morbidity and mortality from RF due to preventable diseases.
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