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NDT Advance Access originally published online on October 11, 2006
Nephrology Dialysis Transplantation 2007 22(2):332-335; doi:10.1093/ndt/gfl494
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

How to tackle the avalanche of chronic kidney disease in sub-Saharan Africa: the situation in the Democratic Republic of Congo as an example

Jean-Marie Krzesinski1, Kiswaya Ernest Sumaili2 and Eric Cohen3

1Division of Nephrology/Transplantation, University of Liège Sart Tilman B35, P.O. BOX 4000 Liege, Belgium, 2Nephrology Unit, University of Kinshasa, P.O. Box 123, Kin Xi, Democratic Republic of Congo (DRC) and 3Nephrology Division, Medical College of Wisconsin, Milwaukee, USA

Correspondence and offprint requests to: Jean-Marie Krzesinski, Division of Nephrology/Transplantation, University of Liège Sart Tilman, Belgium. Email: jm.krzesinski@chu.ulg.ac.be

Keywords: chronic kidney disease; cost of renal replacement therapy; Democratic Republic Congo; developing countries; preventive medicine

The first 150 words of the full text of this article appear below.



   Introduction
 
In developing countries chronic kidney disease (CKD) is a growing problem. In most of sub-Saharan Africa, the vast majority of patients with CKD die because of lack of treatment. Renal replacement therapy is expensive, which makes it unaffordable to the residents of low-income regions. A solution to this problem may lie in preventive interventions. This editorial will focus on the reasons and some ways to reach such objectives.



   Overview of the situation
 
Developing countries now face a double challenge. Besides acute infectious illnesses, they are experiencing the growing problem of chronic diseases, including CKD. In sub-Saharan Africa, the vast majority of patients hospitalized with CKD quickly die because of lack of means for treatment. Moreover, CKD in Africa affects younger adults than in developed countries with a very high risk for disabilities and deaths [1]. This terrifying situation urgently calls for the awareness and aid of the international nephrology community.

Attention to . . . [Full Text of this Article]



   Use of renal replacement therapy
 


   Costs and survival
 


   Causes of the increase in ESRD
 


   Prevention must be first
 


   How to organize prevention? A global approach or an individualized choice?
 


   Pitfalls of prevention: numbers, politics and goals
 


   Manpower problems
 


   Conclusions
 

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