What partnerships have delivered to kidney patients

About four million Kenyans are suffering from Chronic Kidney Disease. FILE PHOTO | NMG 

 

By MARY MATU

According to the Kenya Renal Association, about four million Kenyans are suffering from Chronic Kidney Disease (CKD) with less than 10,000 of them on dialysis.

The association further estimates that 4.8 million Kenyans will be suffering from kidney disease by
the year 2030.

Chronic Kidney Disease and its related complications often go unrecognised and untreated. This is in part because patients with CKD are asymptomatic until advanced stages. Diabetes is one of the most common causes of CKD. Diabetes nephropathy progresses from subclinical disease to microalbuminuria.

Other high-risk factors include hypertension, a family history of kidney diseases, people living with HIV, obesity and use of chronic illness drugs especially for various arthritis including gout.

Many times, the high morbidity and economic burden in patients with end-stage renal disease is attributed to late presentation, delayed diagnosis and limited access to renal replacement therapy.

CKD, like other chronic diseases, can employ the chronic care model design to improve outcomes. Chronic care model includes improving continuity of care, decision support for providers, delivery system design (e.g. multidisciplinary teams and provider collaboration), and patient self-management support.

International guidelines on renal therapy require patients to be dialysed for at least four hours, three times every week.

At Kenyatta National Hospital, the biggest referral hospital in the country, patients wait for an average of eight days from one dialysis session to another contrary to the recommended three days. The long waiting leads to prolonged suffering, heightened anxiety and increased risk of failure of any belated treatment.

Further, delay may, later, require more rigorous treatment.

Nonetheless, there has been tremendous growth in the number of facilities offering hemodialysis services across the country. The number of hemodialysis units has risen from five in 2006 to 54 this year.

KNH has also registered a decline in the number of patients seeking kidney dialysis. The decline is attributed to devolved medical services that have seen dialysis machines acquired by level five hospitals.

Although dialysis machines are available in all level five hospitals, both KNH and Moi Teaching and Referral Hospital observe that Kenya is facing acute shortage of kidney specialists.

Partnerships between the government and private players have seen many dialysis units installed, saving lives, time and money.

The writer is Executive Director, Angelica Medical Supplies.