The increasing burden of chronic kidney disease and end stage kidney failure presents a challenge for both developed and emerging countries. While dialysis and transplantation consumes an ever-increasing proportion of the health budget in countries such as the United States, Japan and Taiwan, there is limited availability of these expensive therapies in the majority of emerging countries and more so in African nations. Aims: To review the prevalence, causes and integrated strategies for treatment and prevention of end stage renal disease (ESRD) in Sub-Saharan Africa (SSA).Materials and Methods: Review of literature and information received from colleagues in Africa. Results: Approximately 70% of the least developed countries of the world are in SSA. Rapid urbanisation is occurring in many parts of the continent, contributing to overcrowding and poverty. While infections and parasitic diseases are still the leading cause of death in Africa, non-communicable diseases are coming to the forefront. There is a continuing brain drain of healthcare workers (physicians and nurses) from Africa to more affluent regions, resulting in large rural areas of Africa having no health professionals to serve these populations. There are no nephrologists in many parts of SSA; the numbers vary from 0.5 per million population (pmp) in Kenya to 0.6 pmp in Nigeria, 0.7 pmp in Sudan and 1.1 pmp in South Africa. Chronic kidney disease (CKD) affects mainly young adults aged 20-50 years in SSA and is primarily due to hypertension and glomerular diseases. HIV-related chronic kidney disease is assuming increasing prominence and often presentslate, with patients 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 <20pmp (and nil in many countries of SSA), with in-centre haemodialysis the modality of renal replacement therapy (RRT) for the majority. Transplantation is carried out in a few SSA countries: South Africa, Sudan, Nigeria, Mauritius, Kenya, Ghana and Rwanda, with most of the transplants being living donor transplants, except in South Africa where the majority are from deceased donors.Prevention programmes are in their infancy in most of SSA, due to lack of personnel and resources. Conclusion: Chronic kidney disease care is especially challenging in SSA, with large numbers of ESRD patients, inadequate facilities and funding, and lack of national or regional registries. Integrated management of CKD and its risk factors is necessary to impact on the burden of ESRD.
{"title":"Integrated management: chronic kidney disease, diabetes mellitus, hypertension","authors":"S. Naicker","doi":"10.21804/16-1-744","DOIUrl":"https://doi.org/10.21804/16-1-744","url":null,"abstract":"The increasing burden of chronic kidney disease and end stage kidney failure presents a challenge for both developed and emerging countries. While dialysis and transplantation consumes an ever-increasing proportion of the health budget in countries such as the United States, Japan and Taiwan, there is limited availability of these expensive therapies in the majority of emerging countries and more so in African nations. Aims: To review the prevalence, causes and integrated strategies for treatment and prevention of end stage renal disease (ESRD) in Sub-Saharan Africa (SSA).Materials and Methods: Review of literature and information received from colleagues in Africa. Results: Approximately 70% of the least developed countries of the world are in SSA. Rapid urbanisation is occurring in many parts of the continent, contributing to overcrowding and poverty. While infections and parasitic diseases are still the leading cause of death in Africa, non-communicable diseases are coming to the forefront. There is a continuing brain drain of healthcare workers (physicians and nurses) from Africa to more affluent regions, resulting in large rural areas of Africa having no health professionals to serve these populations. There are no nephrologists in many parts of SSA; the numbers vary from 0.5 per million population (pmp) in Kenya to 0.6 pmp in Nigeria, 0.7 pmp in Sudan and 1.1 pmp in South Africa. Chronic kidney disease (CKD) affects mainly young adults aged 20-50 years in SSA and is primarily due to hypertension and glomerular diseases. HIV-related chronic kidney disease is assuming increasing prominence and often presentslate, with patients 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 <20pmp (and nil in many countries of SSA), with in-centre haemodialysis the modality of renal replacement therapy (RRT) for the majority. Transplantation is carried out in a few SSA countries: South Africa, Sudan, Nigeria, Mauritius, Kenya, Ghana and Rwanda, with most of the transplants being living donor transplants, except in South Africa where the majority are from deceased donors.Prevention programmes are in their infancy in most of SSA, due to lack of personnel and resources. Conclusion: Chronic kidney disease care is especially challenging in SSA, with large numbers of ESRD patients, inadequate facilities and funding, and lack of national or regional registries. Integrated management of CKD and its risk factors is necessary to impact on the burden of ESRD.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68363689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abstracts of the 12th Congress of the African Association of Nephrology (Accra, Ghana, 20-23 February, 2013)","authors":"A. Assounga","doi":"10.21804/16-1-746","DOIUrl":"https://doi.org/10.21804/16-1-746","url":null,"abstract":"Accra, Ghana, 20-23 February, 2013","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21804/16-1-746","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68363876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Special Article by the participants of the Regional Consultation in the African Region on Cells, Tissue and Organ Donation and Transplantation, Legal and Organisational Aspects, Abuja, Nigeria, July 29-31, 2009.
{"title":"The Abuja Declaration on cells, tissue and organ donation and transplantation","authors":"A. Assounga","doi":"10.21804/15-1-748","DOIUrl":"https://doi.org/10.21804/15-1-748","url":null,"abstract":"Special Article by the participants of the Regional Consultation in the African Region on Cells, Tissue and Organ Donation and Transplantation, Legal and Organisational Aspects, Abuja, Nigeria, July 29-31, 2009.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68363906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Hamzi, E. Mahtat, K. Hassani, M. Asserraji, M. Benyahia, Z. Oualim
Introduction: The association of myelodysplastic syndrome and extracapillary glomerulonephritis is exceptional. Only two other cases have been reported. Reported case: A 52-year-old patient with a history of myelodysplastic syndrome developed rapidly progressive glomerulonephritis. Renal biopsy identified extracapillary glomerulonephritis.Discussion: The association of myelodysplastic syndrome with glomerulopathy is rare and often regarded as fortuitous. Only a few cases are described in literature on the subject. A relationship between the two diseases is possible but the causal link between these two diseases remains unknown. Conclusion: The notion that myelodysplastic syndrome may be associated with various glomerular nephropathies involves looking for renal disease in this haematologic disorder.
{"title":"Myelodysplastic syndrome and extracapillary glomerulonephritis: is there a link?","authors":"M. Hamzi, E. Mahtat, K. Hassani, M. Asserraji, M. Benyahia, Z. Oualim","doi":"10.21804/15-1-750","DOIUrl":"https://doi.org/10.21804/15-1-750","url":null,"abstract":"Introduction: The association of myelodysplastic syndrome and extracapillary glomerulonephritis is exceptional. Only two other cases have been reported. Reported case: A 52-year-old patient with a history of myelodysplastic syndrome developed rapidly progressive glomerulonephritis. Renal biopsy identified extracapillary glomerulonephritis.Discussion: The association of myelodysplastic syndrome with glomerulopathy is rare and often regarded as fortuitous. Only a few cases are described in literature on the subject. A relationship between the two diseases is possible but the causal link between these two diseases remains unknown. Conclusion: The notion that myelodysplastic syndrome may be associated with various glomerular nephropathies involves looking for renal disease in this haematologic disorder.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68363949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Koleganova, G. Piecha, N. Słabiak-Błaż, E. Ritz
Deleterious environmental factors during pregnancy influence fetal development and increase the risk of cardiovascular and kidney disease in adult offspring. Undernutrition, protein restriction, excess salt, corticosteroids, or placental insufficiency disturb kidney development, causing a lower number of nephrons (referred to as nephron underdosing). This in turn leads to hypertension and accelerated loss of kidney function in the adult life of the offspring. The nephron underdosing can be observed with or without intrauterine growth restriction. A lower number of nephrons have been confirmed in humans with hypertension.
{"title":"Prenatal causes of kidney diseases","authors":"N. Koleganova, G. Piecha, N. Słabiak-Błaż, E. Ritz","doi":"10.21804/15-1-749","DOIUrl":"https://doi.org/10.21804/15-1-749","url":null,"abstract":"Deleterious environmental factors during pregnancy influence fetal development and increase the risk of cardiovascular and kidney disease in adult offspring. Undernutrition, protein restriction, excess salt, corticosteroids, or placental insufficiency disturb kidney development, causing a lower number of nephrons (referred to as nephron underdosing). This in turn leads to hypertension and accelerated loss of kidney function in the adult life of the offspring. The nephron underdosing can be observed with or without intrauterine growth restriction. A lower number of nephrons have been confirmed in humans with hypertension.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68363915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abstracts of the 11th Congress of the African Association of Nephrology (Dakar, 16th-19th February 2011)","authors":"A. Assounga","doi":"10.21807/15-1-752","DOIUrl":"https://doi.org/10.21807/15-1-752","url":null,"abstract":"Dakar, 16th-19th February 2011","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68365885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Special article by the participants of the Regional Consultation in the African Region on Cells, Tissue and Organ Donation and Transplantation, Legal and Organisational Aspects, Abuja, Nigeria, July 29-31, 2009.
{"title":"La declaration DAbuja sur le don et la transplantation de cellules, tissus et organes","authors":"A. Assounga","doi":"10.21804/15-1-751","DOIUrl":"https://doi.org/10.21804/15-1-751","url":null,"abstract":"Special article by the participants of the Regional Consultation in the African Region on Cells, Tissue and Organ Donation and Transplantation, Legal and Organisational Aspects, Abuja, Nigeria, July 29-31, 2009.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68364059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. R. Davids, T. Jardine, N. Marais, M. Zunza, J. Jacobs, S. Sebastian
The seventh annual report of the South African Renal Registry summarises the 2018 data on kidney replacement therapy (KRT) for patients with kidney failure in South Africa. In December 2018, the number of patients who were being treated with chronic dialysis or transplantation stood at 10 730, a prevalence of 186 per million population (pmp). Most patients are treated with haemodialysis in the private healthcare sector, where the prevalence was 839 pmp. In the public sector, which serves 85% of the South African population, the prevalence of KRT (67 pmp) remained below the level reported for 1994. Limpopo and Mpumalanga remain the most under-served provinces and Blacks the most under-served population group. The Western Cape province had the highest public sector treatment rates by a large margin and was also where most of the country’s public sector kidney transplants were performed.
{"title":"South African Renal Registry Annual Report 2018","authors":"M. R. Davids, T. Jardine, N. Marais, M. Zunza, J. Jacobs, S. Sebastian","doi":"10.21804/20-1-2583","DOIUrl":"https://doi.org/10.21804/20-1-2583","url":null,"abstract":"The seventh annual report of the South African Renal Registry summarises the 2018 data on kidney replacement therapy (KRT) for patients with kidney failure in South Africa. In December 2018, the number of patients who were being treated with chronic dialysis or transplantation stood at 10 730, a prevalence of 186 per million population (pmp). Most patients are treated with haemodialysis in the private healthcare sector, where the prevalence was 839 pmp. In the public sector, which serves 85% of the South African population, the prevalence of KRT (67 pmp) remained below the level reported for 1994. Limpopo and Mpumalanga remain the most under-served provinces and Blacks the most under-served population group. The Western Cape province had the highest public sector treatment rates by a large margin and was also where most of the country’s public sector kidney transplants were performed.","PeriodicalId":32934,"journal":{"name":"African Journal of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68364546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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