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Problems with a renal replacement programme in a developing country.

S O McLigeyo1, L S Otieno, D M Kinuthia

  • 1Renal Unit, Kenyatta National Hospital, Nairobi.

Postgraduate Medical Journal
|October 1, 1988
PubMed
Summary

In Kenya, a 1984-1986 study of 77 end-stage renal disease patients undergoing hemodialysis revealed a high mortality rate (65%). Challenges included patient condition, resource shortages, and slow transplantation pace.

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Area of Science:

  • Nephrology
  • Public Health

Background:

  • End-stage renal disease (ESRD) management in developing nations presents unique challenges.
  • Hemodialysis and renal transplantation are critical interventions for ESRD patients.

Purpose of the Study:

  • To evaluate the outcomes of hemodialysis initiation for ESRD patients in Kenya.
  • To identify factors contributing to patient survival and treatment success.

Main Methods:

  • Retrospective analysis of 77 ESRD patients undergoing hemodialysis between August 1984 and August 1986.
  • Data collection on patient demographics, dialysis duration, treatment outcomes (death, transplantation, discharge).

Main Results:

  • A high mortality rate of 65% (50 out of 77 patients) was observed during the study period.

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  • Only 2 patients (approximately 2.6%) successfully received renal transplants.
  • Common causes of mortality and treatment failure included critical illness at admission, resource limitations, and slow transplantation processes.

    • Conclusions:

    • The initial implementation of hemodialysis for ESRD in Kenya faced significant challenges, leading to poor patient outcomes.
    • Addressing systemic issues such as staff training, equipment availability, and transplant program efficiency is crucial for improving ESRD care.