The state of renal replacement therapy for children in South Africa: Data from the first report of the re‐established National Renal Registry

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Limited access to renal replacement therapy (RRT) for end stage renal failure (ESRF) for patients in the public sector in South Africa (SA) was reported in 2006.1 Almost a decade later, the first South African Renal Registry annual report was published in 2014 (SARR Report 2012).2 The report gave an overall account of data collected in 2012 for both adult and paediatric chronic RRT. It revealed that only 3182 patients out of 43.6 million people who were dependent on the state for medical care received RRT in the public (state‐funded sector) in 2012. This is a treatment prevalence rate of 73 per million population (pmp). In comparison, 5377 of 8.671 million private sector patients received RRT, yielding a rate of 620 pmp.
Since 1994, with the advent of the new democratic South Africa, the national budget allocation for RRT has not been increased in line with the increased demand.2 There are nine provincial Departments of Health (DOH) in SA which are responsible for funding RRT in the public sector, but not all provide such treatment. Public sector dialysis units have been forced to ration RRT, which has resulted in many patients being turned down for dialysis.1 Private sector RRT is provided through health insurance schemes. ESRF is readily treated in this system because its treatment, including RRT, is classified by legislation as a “primary minimum benefit”. There have been few advocates for children requiring RRT in SA, especially in the public sector. No dialysis registry reports on the state of RRT for children in Africa have been published previously. This study describes the extent and outcome of RRT in children in SA as reported in SARR 2012.
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