Abstract
There are few data on the treatment of kidney disease in sub-Saharan Africa and no formal reports of kidney replacement therapy (KRT) in Ghana. We report data from the newly established Ghana Renal Registry on the prevalence, causes, and modality of treatment of kidney disease in Ghana. Using the web-based data capture system of the African Renal Registry, data were obtained for patients who had KRT in Ghana between January and December 2017. A total of 201 patients started KRT, giving an incidence rate of 6.9 per million population (pmp). There were 687 patients on KRT, a prevalence rate of 23.6 pmp. The median age of prevalent patients was 45.5 years and 63.6% were male. Hypertensive kidney disease was the most common primary kidney disease, reported in 39.9%. The overwhelming majority of patients (96.2%) were treated with haemodialysis, 3.5% had a kidney transplant, and only two were on continuous ambulatory peritoneal dialysis. The incidence and prevalence of KRTtreated kidney failure in Ghana is low, and the patients are younger than those on KRT in high- and upper-middle income countries. The major cause of kidney failure is hypertensive kidney disease and the vast majority of the patients are treated with haemodialysis.
Highlights
The increasing prevalence of non-communicable diseases combined with a high prevalence of communicable diseases threatens the lives of many people in subSaharan Africa (SSA) and is likely to overwhelm the already inadequate health budgets of most African countries
The most common cause of kidney failure (Table 1) was In 2017, the incidence rate of patients starting kidney replacement therapy (KRT) in hypertensive kidney disease, reported in 37.8%, followed Ghana was 7 pmp, which was much lower than the rate of by kidney failure of uncertain cause in 28.5%, diabetic 26 pmp reported in South Africa [8] and 127 pmp in nephropathy in 9.2%, and glomerulonephritis in 7.7%
The prevalence of KRT in Ghana was 24 pmp infection was present in 3.8% of the patients, 3.9% were and again this was much lower than the 183 pmp reported hepatitis B surface antigen positive, and 0.8% were hepatitis from South Africa [8] and the 854 pmp reported from
Summary
The increasing prevalence of non-communicable diseases combined with a high prevalence of communicable diseases threatens the lives of many people in subSaharan Africa (SSA) and is likely to overwhelm the already inadequate health budgets of most African countries. Chronic kidney disease (CKD) is common in SSA, with systematic reviews estimating the prevalence in adults to be between13.9% and 15.8% [1,2]. There are few data on the incidence of kidney failure in SSA, but one study estimates this to be 239 per million population (pmp) in patients with diabetes mellitus and hypertension [4]. The African Renal Registry was formally established at a workshop held just before the World Congress of Nephrology in Cape Town, in 2015 [12]. Arising from this initiative, the Ghana Renal Registry was established in 2016 and here we report its first set of data, from 2017. The Ghanaian health system includes public institutions under the Ghana Health Service, teaching hospitals which are controlled by the Ministry of Health, and several private health centres mostly situated in the
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