Ghana
Ghana
The Ghana Renal Registry - a first annual report
Ghanaian nephrology looks to change the course of kidney disease. In a country where only 5% of ESRD patients can continue hemodialysis after 3 months and 1% after one year, understanding how kidney disease affects the population is critically essential. Among other benefits, a registry of kidney disease patients allows the nation to allocate scare resources towards managing the burden of kidney disease (Figure 1).
Figure 1: Regions of Ghana with (dark green) and without dialysis centers
Figure 2: Benefits of renal registries | Courtesy of Dr. Farid Giris Ghilli and Dr. Damian Fogarty
Before we move onto to the key findings in the Ghanaian registry, let's review the value of registries. Many countries have them, and for good reason. Registries help decision-makers uncover gaps in care. The data in registries identify is used to quantify the severity of disease burden so that the right amount of scarce resources can be brought-to-bear to the problem(s). Registries may seem to be commonplace since so many nations have them; that should be a testimony to their value to healthcare.
And now that we have a better appreciation of registries, let's go back to the Ghanaian effort to build one. The registry captures the severity and distribution of kidney disease. Who cares for those patients? Nearly all nephrologists in Ghana work in just one of two academic centers. These two centers are responsible for 96% of the ESRD patients receiving hemodialysis, 0.3% receiving peritoneal dialysis, and 3.6% who are living with a kidney transplant.
Unlike most Western nations, diabetic kidney disease is not one of the most common etiologies of kidney failure (Figure 3). Nearly a third of patients have kidney disease of unknown etiology, making treatment extremely difficult. Most patients are younger (< 65 years of age) than patients in North America or Western Europe. As a non-communicable disease of the young, Ghana has identified an unmet medical need in a critical segment of its population.
Figure 3: Etiologies of kidney failure in Ghana (zoom in for details)
Registry data may not seem like a winning team, but it represents a fundamental effort to quantify the severity of kidney disease. Without such data, subsequent research and management efforts would not reach maximal effectiveness (Video 1).
Video 1: Value of a registry | Courtesy of the Dr. Damian Fogarty