SOUTH AFRICA—The African Association of Nephrology has reported that the prevalence of chronic kidney disease (CKD) in Africa is rising, posing substantial challenges to public health and healthcare systems.

 This growing trend was highlighted during the commemoration of World Kidney Day on March 14, 2024, when the association presented a paper penned by 13 senior officials emphasizing the urgent need for attention and action to treat CKD in the region.

The authors of the study paper “Transporting Sodium-Glucose Cotransporter-2 Inhibitors to the African Continent: Challenges and Solutions” urged for collaborative efforts to develop viable ways to reduce the continent’s growing CKD incidence.

This presentation aligns with the theme of World Kidney Day, calling for a paradigm shift in how CKD is handled and managed in Africa.

Furthermore, it advocated for a thorough and practical clinical approach to screening, diagnosis, and treatment, emphasizing the importance of equitable access to care and best pharmaceutical practices.

The paper highlights the worrying trends in CKD prevalence in Africa, driven by a triple burden of health concerns, with CKD prevalence varying from 6% to 20% across areas, indicating a huge strain on healthcare systems.

CKD , a degenerative disorder characterized by a decrease in renal function, which has major ramifications for one’s health and wellbeing.

Chronic kidney disease is the world’s tenth biggest cause of mortality, impacting approximately 850 million people.

The majority of these instances are concentrated in low- and middle-income nations, with Africa carrying a substantial amount of the burden.

The increased incidence of noncommunicable diseases such as diabetes and hypertension, combined with chronic infections like HIV and hepatitis B and C, exacerbates the problem.

Diabetes affects roughly 24 million adults in Africa, with the number expected to climb to 33 million by 2030 and 55 million by 2045.

The challenges Africa faces in combating CKD are also exacerbated by socioeconomic differences, limiting access to key healthcare resources and accentuating the effects of CKD across the continent.

Limited financial resources, low health knowledge, and inadequate medical reimbursements are some of the most prominent issues.

Furthermore, the lack of CKD registries and real-world data exacerbates efforts to address the problem.

The report emphasizes the importance of developing training materials, gathering regional statistics, and making healthcare more accessible as key steps toward eliminating these barriers.

CKD is recognized at a younger age in Africa than in higher-income regions, with many CKD patients in Sub-Saharan Africa (SSA) being diagnosed with renal failure, highlighting the devastating repercussions of resource restrictions, restricted access to basic care services, and inadequate screening.

Unfortunately, medication at this advanced level is frequently ineffective for many patients, particularly in SSA, underscoring the critical importance of early detection and fast treatment in CKD to avoid kidney failure and save lives.

Recognizing the difficulties that existing diagnostic procedures present, the authors suggest practical alternatives such as dipstick detection for proteinuria, providing a cost-effective screening strategy to eliminate diagnostic hurdles and increase access to care for underprivileged groups.

The authors also emphasize the importance of political will, capacity building for healthcare personnel and patients, economical pricing, and pharmaceutical availability in achieving kidney health for all in Africa and beyond.

Speaking during the paper’s presentation, Professor Abdou Niang, MD, FWACP, Head of the Nephrology Department at Cheikh A. Diop University in Dakar and President-elect of the African Association of Nephrology, pointed out that CKD is a silent killer that must be detected early to provide an effective response to avoid going to dialysis, which is out of reach for most African populations.

On his part, Dr. Hussein Bagha, Consultant Physician and Nephrologist at MP Shah Hospital in Nairobi, Kenya, further emphasized that CKD progression can be significantly delayed if diagnosed early.

He explained that the use of SGLT2 inhibitors together with RAAS blockers can significantly delay the progression of CKD to End-Stage Kidney Disease (ESKD) requiring renal replacement therapy, by up to 25 years if diagnosed early.

AstraZeneca’s Medical Director, Dr. Khomotso Mashilane, stated that the company was dedicated to supporting projects aimed at reducing the prevalence of chronic kidney disease in Africa.

She commended the authors of this position paper for their comprehensive and sober representation of the challenges faced in managing CKD on the continent, noting that their emphasis on the potential value of SGLT2 in addition to standard care is a critical step toward reducing the burden and morbidities associated with CKD in Africa.

As the continent grapples with the growing burden of CKD, it is essential to make a coordinated effort to improve quality kidney care across Africa.

Significant progress may be achieved toward improving outcomes and guaranteeing a healthy future for all through collaboration, innovation, and a dedication to fair healthcare.

Recognizing the clear benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in managing CKD is central to the paper’s proposal, since these breakthrough drugs show promise in lowering CKD complications and providing new pathways for improving outcomes.

Furthermore, incorporating SGLT2 inhibitors into standard care regimens will increase their impact and suit the changing needs of CKD patients across Africa.

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