New efforts to combat kidney disease

The Ministry of Health has developed a strategic plan to tackle the worrying number of patients suffering from Kidney disease or Renal Health. The call for focus on kidney disease is a reaction to an already existing problem, where cases are being identified in all levels of health care.Although there are no exact figures on the prevalence of kidney failure in Rwanda, there is an estimation of 1,100 cases that require dialysis and more than 33,000 cases country wide with chronic renal health which is reversible. Dialysis is a procedure that is a substitute for many of the normal duties of the kidneys, and it is said to be expensive, according an expert physician, a procedure, which is performed once a month, costs between Rwf900,000 to 1.2 million, depending on which procedure one uses.It is estimated that the prevalence of end-stage kidney disease in Sub-Saharan Africa is 100 cases per million people.Now health officials say that since government cannot, through its budget support all these people to get the treatment have suggested that a comprehensive eligibility criterion be carried out for the beneficiaries and also put in place preventive measures to curtail the number of new cases.Dr Joseph Ntarindwa, Consultant Nephrologist at King Faisal Hospital says deaths caused by kidney failure and the increase in number of patients requiring dialysis cannot be ignored.“The cost of dialysis is too high to be afforded by most of the patients and there are no kidney transplant services in the country to rely on. The total burden of kidney disease is currently bigger than government budget can handle,” Ntarindwa who was part of the team that developed the plan told The New Times.To fight the increasing number of patients, more effort will be put in preventive areas, according to the new policy. The policy suggests that to detect this disease there is need for screening measures for all patients with diseases like diabetes, hypertension, malaria and other infections, hereditary conditions, drugs and toxins and pregnancy related incidences, among others. “Government will ensure availability of curative services and accessibility through medical insurances,” the policy document reads in part.According to Ntarindwa, government will assist those who fulfil the set eligibility criteria for support. Ntarindwa says haemodialysis which is the most affordable type of dialysis can only be done in specialized centres. King Faisal Hospital is the only health facility which has a running haemodialysis unit but its capacity needs to be expanded, he said, adding that the similar unit in Butare University Hospital (CHUB) had to close down recently due to technical problems.Health experts say haemodialysis requires patients to live in close proximity to the hospital because it requires three times a week hospital visits. This will require even distribution of dialysis units in the country to improve geographical proximity.There will also be need to improve capacity of laboratories in all health facilities to detect early kidney disease.The policy also indicates the need to address the major shortage of health workers with required skills to render service in renal health. While there are only two internists with specialised skills in nephrology in the country, the number of practicing renal nurses is very inadequate with none of them fully trained as a renal nurse.“In many fields of renal care, there are no trained people at all. These include renal technicians, dieticians and there is nobody capable of maintaining dialysis machines,” reads the document which according to Ntarindwa, has been adopted by the Ministry of Health. In addition, there is no surgeon in the country capable of doing kidney transplantation and we have no pathologist leave alone one specialized in renal pathology and no tissue typing technologist.The policy indicates that although reasonable achievements have been made in many aspects of health care, kidney diseases remain an increasing challenge to the Rwanda health sector.

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New efforts to combat kidney disease