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Problems with a renal replacement programme in a developing country.
  1. S. O. McLigeyo,
  2. L. S. Otieno,
  3. D. M. Kinuthia,
  4. S. K. Ongeri,
  5. F. K. Mwongera,
  6. S. G. Wairagu
  1. Renal Unit, Kenyatta National Hospital, Nairobi.


    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.

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