The impact of kidney failure

Kidney (renal) failure is a very serious condition and a worldwide problem. The kidneys play a critical role in the clearance of waste from the body. If failing kidneys are left untreated then the person affected will die, usually within a few weeks. There are many different diseases which can result in kidney failure.

In the developed world, patients with advanced kidney failure usually start on dialysis, and (if a suitable kidney donor is available) move to kidney transplantation. Renal transplantation is now a very successful procedure and offers the best survival and quality of life for these patients. It is also a cost-effective procedure. By comparison, dialysis is expensive and offers a poor quality of life - with the need to be on a dialysis machine often several times a week.

In developing countries many patients die. They either do not receive any treatment at all, and therefore die, or the more fortunate minority get dialysis which often has to be self-funded. A poor quality of life on dialysis is compounded by the enormous expense that patients must endure to simply stay alive. Unfortunately, many patients run out of money and cannot sustain their life on dialysis, and then die. Some patients, particularly women and children, never reach the point of diagnosis, and are certainly less likely to receive treatment if they do, as they are unlikely to be the breadwinner in the family and their death therefore will have less of an impact on the family unit than that of the breadwinner who is usually male.

It is known that the average life expectancy of someone in Nigeria who starts dialysis is just three months. This isn’t because of infections or other medical issues - but because this is the average time for them to run out of money to pay for the dialysis.

A well-timed, living donor transplant can avoid the need for the dialysis and allow patients to live with a good quality of life for many years sustained only by the relatively small expense of medication which stops the body rejecting the transplant. As such, a need undoubtedly exists to increase the availability of living renal transplantation in the developing world. However, in these areas the skills required to provide this are usually absent.

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