Dans la suite de trois publications en néphrologie de notre institution, voici pour lecture une thèse présentée à l’Université de Boston sur la situation de la prise en charge de l’insuffisance rénale aiguë en Afrique sub-Saharienne (avec une situation pays par pays). Les travaux réalisés sur le sujet par les équipes de Néphrologie et de Pédiatrie de la RDC y ont été cités. Un grand honneur et une grande reconnaissance pour la Faculté de Médecine de l’Université de Kinshasa.
Cette thèse pourrait permettre d’élaborer de futurs projets d’étude pour combler certains vides d’information sur cette prise en charge dans notre milieu tant chez l’enfant que chez l’adulte.
CONFRONTING THE GROWING BURDEN OF KIDNEY DISEASE:
THE SUB-SAHARAN LANDSCAPE
HALEY I. TUPPER
by HALEY I. TUPPER
B.A., University of Pennsylvania, 2012
Submitted in partial fulfillment of the requirements for the degree of Master of Science
Submitted in partial fulfillment of the requirements for the degree of Master of Science
ABSTRACT
This report seeks to describe the status of kidney disease and renal replacement
therapy in lower-resource settings, particularly sub-Saharan Africa. Acute kidney injury
and transplantation are included on a limited basis because it is impossible consider the
renal replacement therapy landscape at the exclusion of either. As in the rest of the
developing world, chronic kidney disease and end-stage renal disease place a sizable and
rapidly growing burden on sub-Saharan Africa, and Africans face a double-burden of
disease from communicable and non-communicable diseases. Meanwhile, renal
replacement therapy and the subspecialty of nephrology are expanding in sub-Saharan
Africa, from non-existence in many countries to a limited, tentative subsistence, largely
with the support of international organizations and the dedication of local nephrologists.
Hemodialysis is the most common form of renal replacement therapy in sub-Saharan
Africa, but peritoneal dialysis services, particularly for acute kidney injury, are growing
and renal transplants are performed in a few sub-Saharan countries. Nonetheless, in the
majority of sub-Saharan Africa, maintenance dialysis is still only available to the wealthy
urban few. Although peritoneal dialysis may seem more feasible in the developing world
than hemodialysis for multiple reasons, it is still fraught with challenges that make
widespread implementation presently unadvisable. As renal replacement therapy is costly
therapy in lower-resource settings, particularly sub-Saharan Africa. Acute kidney injury
and transplantation are included on a limited basis because it is impossible consider the
renal replacement therapy landscape at the exclusion of either. As in the rest of the
developing world, chronic kidney disease and end-stage renal disease place a sizable and
rapidly growing burden on sub-Saharan Africa, and Africans face a double-burden of
disease from communicable and non-communicable diseases. Meanwhile, renal
replacement therapy and the subspecialty of nephrology are expanding in sub-Saharan
Africa, from non-existence in many countries to a limited, tentative subsistence, largely
with the support of international organizations and the dedication of local nephrologists.
Hemodialysis is the most common form of renal replacement therapy in sub-Saharan
Africa, but peritoneal dialysis services, particularly for acute kidney injury, are growing
and renal transplants are performed in a few sub-Saharan countries. Nonetheless, in the
majority of sub-Saharan Africa, maintenance dialysis is still only available to the wealthy
urban few. Although peritoneal dialysis may seem more feasible in the developing world
than hemodialysis for multiple reasons, it is still fraught with challenges that make
widespread implementation presently unadvisable. As renal replacement therapy is costly
and currently unaffordable on a large scale for most of these countries, emphasis must be
on identifying at-risk populations through screening and low-cost treatment or
management of risk factors to mitigate chronic kidney disease.
on identifying at-risk populations through screening and low-cost treatment or
management of risk factors to mitigate chronic kidney disease.
