Global Disparities in Access and Utilization of Dialysis - Africa, the Disadvantaged Continent

Area of Science:

• Nephrology
• Public Health
• Healthcare Disparities

Background:

• Global burden of chronic kidney disease (CKD) is rising, with substantial inequities in management and treatment access in Africa.
• Existing literature highlights significant gaps in dialysis access and utilization within African nations compared to global standards.

Purpose of the Study:

• To review and analyze disparities in the access and utilization of dialysis (hemodialysis and peritoneal dialysis) in Africa.
• To compare African dialysis statistics with other global regions and median values.
• To identify the health, economic, and societal impacts of these disparities and propose actionable solutions.

Main Methods:

• Systematic review of existing literature on CKD management and dialysis in Africa.
• Comparative analysis of dialysis access and utilization rates in Africa versus global medians and other regions.
• Identification of contributing factors to disparities and potential interventions.

Main Results:

• In-center hemodialysis is available continent-wide but shows significant access and utilization gaps across African countries.
• Home hemodialysis is rarely available, and peritoneal dialysis utilization is considerably lower than global averages.
• These disparities result in adverse health outcomes, reduced quality of life, increased morbidity, and preventable mortality.

Conclusions:

• Addressing CKD disparities in Africa requires a multi-faceted approach including prevention, enhanced access to medicines, and increased peritoneal dialysis use.
• Investment in training and retaining nephrology workforce, improving kidney transplantation access, and local production of consumables are crucial.
• Increased government funding for kidney care is essential to improve patient outcomes, particularly in sub-Saharan Africa.