So many renal patients, too few specialists

Dr Ahmed Twahir, Consultant Nephrologist at Aga Khan University Hospital with Moses Ng’ang’a (centre), a kidney donor and Pius Ngeti (left), a kidney recipient during a kidney transplant support group event organised to sensitise kidney disease patients about kidney transplants as well as promote local transplant surgeries. PHOTO| FILE| DAILY NATION

Kenya has only 29 nephrologists and 260 nephrology nurses handling kidney complications, including dialysis – 24 specialists to manage adult patients and five for children.
This has led to the stretching of renal facilities at various public hospitals, making it difficult for renal patients to access timely and affordable treatment. Further, there are only eight transplant surgeons, and none for children, at the Kenyatta National Referral Hospital and the Moi Teaching and Referral Hospital in Eldoret, to cater to the estimated one million Kenyans who suffer from kidney ailments, with 10,000 patients diagnosed every year, according to data from the Ministry of Health.


A 2016 report in the Clinical Kidney Journal indicated that Kenya, Uganda, Rwanda, Ghana, Nigeria and Sudan are among countries in Africa with less than one nephrologist for every one million people. According to claims by health workers, a shortage of specialists in the public sector is leading to the deaths of patients who cannot afford treatment costs in private hospitals.

Health experts cite several factors which have contributed to a shortfall of kidney specialists in the country. Several years of training combined with burn-out has led to declining interest in nephrology among trainees pursuing medical courses. Therefore, experts recommend that undergraduate medical trainees and medics pursuing master’s degrees should get some mandatory training on kidney ailments to address the huge gap in renal healthcare.

A shortage of specialists has seen some patients who need transplants seek treatment in foreign hospitals.

Dr Phillip Chepting’a, a kidney specialist at MTRH, who handles over 2,000 patients every month, against a World Health Organisation recommendation of one doctor to 300 patients, says that some crucial tests including cross-matching are not only expensive, but are also only done in South Africa.

“There is need for government to ensure that the tests can be done locally to reduce costs and save time. Some samples take about two weeks to return from South Africa,” said Dr Chepting’a in an interview with HealthyNation.


To bridge the gap, some hospitals have come up with exchange programmes that help Kenyan doctors gain skills in the renal field. For example, Dr Seno Saruni, has been seconded to Apollo Hospitals in India courtesy of St Luke’s Orthopaedic and Trauma Hospital in Eldoret, for a two-year training. Doctors from Apollo Hospitals perform kidney transplants in Kenya to build the capacity of local doctors in the renal field.

Moreover, at Moi University School of Medicine, a curriculum is being developed for both adult and children nephrologists, with plans to train thousands of nephrologists and transplant surgeons in the coming years.


The average cost of a kidney transplant is about Sh500,000 in a public hospital for patients without a health cover from the National Hospital Insurance Fund. The charges range from Sh1 million to Sh1.5 million in private hospitals. Prior to the operation the recipient has to use immunosuppressants to lower immunity so that the transplanted kidney is not attacked by the immune system. These drugs cost about Sh20,000 monthly.

Alexander Lopongurei, became a beneficiary of the Apollo-St Luke’s exchange programme after a two-year painful journey marked by frequent visits to the renal unit at MTRH for dialysis.