Senegal
Senegal (République du Sénégal)
Global Dialysis Perspective: Senegal
Senegal, like so many sub-Saharan nations, is thought to have many deficiencies for end-stage kidney disease. The country has, as of 2020, only 26 hemodialysis centers and *one* peritoneal dialysis center spread across a nation of 16+ million people (Figure 1). Nearly 75% of end-stage kidney patients die because they cannot obtain hemodialysis; this despite the fact that all hemodialysis treatments offered in the public sector are free.
This year's team focuses on highlighting the unmet needs of Senegalese kidney patients. Even though hemodialysis and access surgeries are free (in the public sector), ancillary services, such as treatment for bone-mineral disorders (vitamin D, calcium), anemia (erythropoietin-stimulating agents), anti-hypertensive medications, hemodialysis catheters or arteriovenous grafts are expenses shouldered by the patient (Figure 2). Most patients are unsuccessful at meeting these financial obligations. Perhaps as a result, certain aspects of dialysis care have been modified. Nephrologists see each patient approximately 8 times per month. Labs are done every 2 months. Nearly 40% of the patients receive incremental dialysis (two times per week).
Figure 2: Costs for dialysis treatment (zoom in for details)
Figure 1: The basics of dialysis treatment in Senegal (zoom in for details)
This is a valiant contribution from the Senegalese team. Highlighting the financial burdens placed on patients increases awareness. The quantify demanded for dialysis services exceeds the supply and this will drive prices upward unless governmental intervention(s) is implemented (e.g., price ceilings) or cheaper forms of dialysis are expanded (e.g., peritoneal dialysis) (Figure 3).
Figure 3: Costs of peritoneal dialysis | Presented at the 2021 International Society of Nephrology meeting | Courtesy of Drs. Aakash Shingade and Brett Cullis (zoom in for details)