title: Problems with a renal replacement programme in a developing country.
abstract: Since August 1984 patients with end-stage renal disease in Kenya have been started on haemodialysis with a view to renal transplantation. In a two year period (August 1984-August 1986) 77 patients mean age 29.6 years (49 males), have been dialysed. The mean duration on dialysis prior to death or transplantation was 2.9 months (range 1 day to 11 months). Fifty patients (65%) died while on dialysis, including 2 who had had unsuccessful transplantation. Fourteen patients were still on dialysis, 11 had discharged themselves to peripheral hospitals for conservative management, and 2 had had successful renal transplantation. The possible causes of this abysmal experience include admission of critically ill patients, shortage of trained staff, over-dependence on arteriovenous shunts for vascular access, lack of centralization of patient management, recurrent shortage of essential equipment and reagents and a slow pace of transplantation.
authors.affiliation: Renal Unit, Kenyatta National Hospital, Nairobi.
authors.forename: S O
authors.initials: SO
authors.lastname: McLigeyo
authors.forename: L S
authors.initials: LS
authors.lastname: Otieno
authors.forename: D M
authors.initials: DM
authors.lastname: Kinuthia
authors.forename: S K
authors.initials: SK
authors.lastname: Ongeri
authors.forename: F K
authors.initials: FK
authors.lastname: Mwongera
authors.forename: S G
authors.initials: SG
authors.lastname: Wairagu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003906:Developing Countries; D005260:Female; D006801:Humans; D007630:Kenya; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors