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Kidney Dialysis Statistics from Kenyatta National Hospital


                                     KIDNEY DIALYSIS STATISTICS

   Counties relieve Kenyatta National Hospital of the referral burden

Prepared by Shem Sam
The Ministry of Health estimates that one million Kenyans suffer from kidney related diseases.  The figure is consistent with global kidney disease prevalence which lies between 8-16% whereas that of developing countries gravitates at 10%.  The WHO estimates that one in every five men and one in every four women in Kenya aged between 65 and 74 have chronic kidney disease. The Ministry of health notes that 10,000 cases of kidney disease are diagnosed annually.
Referral burden
Between 2010 and 2012, Kenyatta National Hospital (KNH) received 150 referral cases monthly.  During that period KNH had only one nephrologist (kidney specialist): much lower than required 20 specialists, in line with Vision 2030. In 2012, the country had 200 dialysis machines but only 13 of them were in operation.
Presently, KNH has acquired 13 dialysis machines and treats 60 patients daily; 35 of whom undergo dialysis. The hospital also performs 30 kidney transplants annually. The Renal Unit recommends that three dialysis per week costing Ksh 13,000 are required for effective treatment. On the same note, records from the hospital indicate that kidney transplant costs two million Kenya shillings. These costs are too high for patients.

Decline in Referral Cases
However, in the recent past, resulting from devolved medical services, KNH has registered decline in numbers of patients seeking kidney dialysis. The decline is attributed to dialysis machines acquired by level five hospitals in Kisii, Kisumu, Eldoret, Embu, Nyeri, Kakamega, Mombasa and Nyeri Counties.  The KNH Renal Unit figures reveal that majority of Kidney patients referred to KNH came from Kisii and Nyeri Counties. Consequently, both counties have not only acquired the dialysis machines but also subsidized the cost of dialysis by from Ksh 13,000 to Ksh4,500. As such the number of kidney patients referred to KNH has reduced by half, that is, from 150 to 75 cases monthly. Basically, current referral cases require more specialized treatment.

Existing Gap
Although dialysis machines are available in almost all level five hospitals, there are few kidney specialists in the country. In that regard, the Kenyan Government should train Nephrologists, Paramedics and other health staff to respond to the increasing number of patients. Both KNH and Eldoret Moi Referral Hospital observe that Kenya is facing acute shortage of Kidney specialists.

Distribution of Kidney Dialysis Machines in Public Hospitals
1    Kenyatta National Hospital    13     60     GOK supported by Egyptian Agency of Partnership for Development, Safaricom
2    Moi Referal Hospital Eldoret    5    12     GOK
3    Embu    2    9    County Gobt also supported by Safaricom
4    Nyeri    9    18    County Govt,
5    Kakamega    1    3    County Govt also supported by Safaricom
6    Meru    2     9    County Govt  also supported by Safaricom
7    Kisii    4      20     County Govt also supported by KCB
8    Mombasa    7     40    County Govt also supported by Safaricom,  &Ahmed Al Falasi
9    Nakuru    5     10    County Govt also supported by Safaricom
10    Kisumu    2+(16 Ultra-Modern)     822      County Govt also supported by KCB, Safaricom
11    Thika    2     7    County Govt supported by DOWS Chemicals Co.
12    Machakos    1    2    County Govt supported by Safaricom
13    Naivasha Level 3    1    2    County Govt also supported by DOWS Chemicals.Co.
14    Bomet Level 3     1    2    County Govt
    County Capacity    51    944   
    National Hospital Capacity    18    82   
     Increament in Capacity    3 times    11.5 times   

The two national referral facilities, KNH and Moi Eldoret, have 18 dialysis machines whereas county level 5 and 3 hospitals have 51. It implies that county hospitals have 3 times more dialysis machines than the national referral facilities.
In terms of capacity to conduct dialysis, the county hospitals have eleven and half times (944 sessions per day) more capacity compared to national referral facilities (82 sessions per day). Worth noting is the fact that the enormous capacity of Kisumu Level 5 hospital is attributed to16  ultra-modern dialysis machines, each of which that can perform 48 session per day.
As such, the counties that offer faster and cheaper dialysis are Kisumu, Mombasa and Nyeri in that respect. Averagely, kidney dialysis sessions now cost Ksh4,500 from Ksh 13,000.

With counties acquiring 51 dialysis machines with capacity to conduct a sum total of 944 dialysis sessions per day, a patient with kidney disease is eleven and half times less likely to go to KNH or Moi Referral Hospitals, when cost remains constant.
More still, with reduced dialysis and transport costs, a kidney disease patient will most unlikely go to KNH.

The COG Chairman

H E Nanok

His Excellency Josphat Koli Nanok,  Governor Turkana County and the Chairman of the Council of Governors.


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