Abstract
Aim: To review available literature on the burden of kidney diseases in Africa from the perspective of acute kidney injury and chronic kidney disease. It also aims to provide information on the status of renal replacement therapy activities, and the emerging roles ofthe double burden of communicable and non communicable diseases interfacing with the kidney in a continent with distinct environmental, socio-cultural, infrastructural and economical peculiarities.
Methods: A literature search was conducted on the aetiopathogenesis, management options of peculiar diseases causing both acute kidney injury and chronic kidney diseases and renal replacement therapies in Africa. The literature review used the electronic database; Medline, Pubmed and the African Journal on line (AJOL). Information related to the topic over a 30-year period (1979-2009) was retrieved and reviewed. Search terms used were ; acute renal failure in Africa, acute kidney injury in Africa, chronic renal failure/chronic kidney disease in Africa, heamodialysis, peritoneal dialysis and transplantation in Africa.
Result: Nephrotoxins and infections are prevalent causes of acute kidney injury (AKI) in the continent. Chronic glomerulonephritis, hypertension and lately diabetes mellitus are still major peculiar aetiological factors of chronic kidney disease (CKD). A variety of renal syndromes which can be acute or chronic is associated with the Human immunodiefficency virus infection and its magnitude and consequences portend a grim reality in a continent that is least prepared to respond appropriately. Renal replacement therapy therapy is limited to less than five percent of those that need it especially in the sub-Saharan Africa.
Conclusion: There is a huge burden of AKI and CKD in Africa from the perspective of their peculiar aetiological considerations. The status of renal replacement therapy activities is poor except in North and South Africa. The major challenges of kidney diseases in Africa include the high prevalence, delayed presentation, cost of treatment, general lack of preventive measures, lack of epidemiological studies and general lack of functional renal registries. There is thus a need for a strong advocacy for support for renal care in Africa.
Keywords: Kidney, socio-cultural, aetiopatho- genesis, heamodialysis; renal failure
Résumé
But: Passer en revue Les Documents disponibles sur les charges des maladies rénales en Afrique dans la perspective de l’insuffisance rénale aiguë et la maladie rénale chronique. Il vise également à fournir des informations sur le statut de la fonction rénale des activités de remplacement thérapeutique, et les nouveaux rôles de la double charge des maladies transmissibles et non transmissibles en interface avec le rein dans un continent des spécifiés environnementales, socioculturelles, infrastructurelles et économiques.
Méthodes: Une recherche bibliographique a été menée sur l’ étiopathogénie, les options de gestion des maladies particulières provoquant à la fois l’insuffisance rénale aiguë et de maladies rénales chroniques et des thérapies de remplacement rénal en Afrique. La revue des documents a utilisé des données de base électronique; Medline, Pubmed et le Journal Africain en ligne (JAL). Les informations relatives à ce sujet au cours d’une période de 30 ans (1979-2009) ont été récupérées et examinées. Les termes de recherche utilisés étaient : l’insuffisance rénale aiguë en Afrique, l’insuffisance rénale chronique en Afrique, l’hémodialyse, la dialyse péritonéale et la transplantation en Afrique.
Résultat: Les néphrotomies et les infections sont les causes courantes de l’insuffisance rénale aiguë sur le continent. La glomérulonéphrite chronique, l’hypertension et le diabète tardif sont encore les principaux facteurs étiologiques particuliers de CKD. Une variété de syndromes rénaux qui peut être aiguë ou chronique est associée à l’infection par le virus immunodéficience de l’homme, son ampleur et les conséquences laissent présager une triste réalité sur un continent qui est le moins disposé à répondre de manière appropriée. La thérapie par remplacement rénal est limitée à moins de cinq pour cent de ceux qui en ont besoin en particulier en l’Afrique sub-saharienne.
Conclusion: Il ya une charge énorme de la AKI et CKD en Afrique du point de vue de leurs propres considérations étiologiques. Le statut de la fonction rénale des activités de remplacement thérapeutique est faible, sauf en Afrique du nord et l’Afrique du Sud. Les défis majeurs des maladies rénales en Afrique comprennent la forte prévalence, la présentation tardive, le coût du traitement, le manque général de mesures préventives, le manque d’études épidémiologiques et le manque général de registres fonctionnels rénaux. Il ya donc un besoin urgent d’un plaidoyer fort pour soutenir les soins rénaux en Afrique.
Correspondence: Prof. A. Akinsola, Department of Medicine, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria. E-mail: wakinsol46@yahoo.co.uk
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