DR M.O.G.

OWITI

OBJECTIVES
Creat awareness on Burden of renal disease
Appreciate Challenges in diagnosis, treatment, and

prevention of renal diseases. Encourage you to join the fight.

DISEASE BURDEN IN AFRICA 2009

Hiv AIDS MALARIA ACUTE LOWER RESP TRACT INFECTION DIARRHOEA PERINATAL MEASLES MATERNAL TB CONGENITAL MAL RTA

CAUSES OF DEATH IN AFRICA 2009

HIV LOWER RESP TRACT INFECT MALARIA DIARHOEA PERINATAL MEASLES TB CEREBROVASCULAR ISCHAEMIC HEART DISEASE MATERNAL

CT

2009
Including satellites

SCENARIO
CKD- emerging world wide health problem.
Slow Shift from major cause of death & morbidity,

from nutritional & infections to NCD. CKD creeps on silently in DIABETICS/ HYPERTENSIVES. Sudden presentation in ESRD. Referral to nephrologist for dialysis. Patient too poor to afford.

CHALLENGES

CKD not major cause of morbidity & mortality Lack of data/reliable statistics in African states RRT- not affordable/ not available Diagnosis often made late. No histological diagnosis. Poor control of DM & HPT. Health personnels knowledge on renal disease. Health education to the public/ lack of trust of Drs. Alternative medicines. Culture-diseases are cured not controlled. LACK OF POLICY

Factors for late presentation

alternative medicine Lack of education Self diagnosis Intervention from non-qualified staff/ nurses/Clinical Offficers Poverty. Medical personnel holding on till in ESRD. Few renal specialists.

approach
Education- training medical officers

-General physicians. Public awareness/ campaigns Including world kidney , world diabetic days. Policy development Biopsy, Early referrals,& consultations,interpretation of results- urinalysis, u/cs ,BGAs, electrolytes. Supervision.

60

RRT AVAILABILITY & AFFORDABILITY

ORIGINALLY Capital city only
The only ref center in east & central Africa. 7 nephrology fellows. Good private hospitals. Few fellows in neighboring countries green pastures. India cheap, donor . TX- expensive.

Late diagnosis
Too late referrals with only option of dialysis
Lack of optimal mx of DM, HPT. e-GFR, Urinalysis-not commonly done. Health personnels knowledge/work pressure. Public knowledge, cultural beliefs. Alternative medicine.

Histological diagnosis lacking

Few trained renal pathologists
Only light microscopy. Costs of biopsy &histology. Lack of biopsy needles, team. C4/3-expensive.

WAY FORWARD?
Screening AMPATH. POLICY-MOH. Who to dialyse, diseased Tx,

PROTOCALS- Tx, dialysis unit set up, dialysis.

Dialysis machines in gvt hospitals. NHIF

Training- biopsy, more renal teams

Public awareness. Active KRA.

Improved teaching & emphasis on renal medicine in

Medical schools.

Protocols affordable
MMF+CYA FOR 3 DAYS PRIOR TO TX
NO INH.

Transplant team & first tx

Dialysis unit.

Vascular access

Vascular access

Peritoneal dialysis

Should we go

the HIV WAY?

Thank You

77