Table 1.
Demographics, health expenditure, and cost of kidney replacement therapy in the ISN African region15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34
| Country | World Bank income level | Area (km2) | Total population | Prevalence of CKD % (95% CI) | DALYs to CKD per 100,000 rate (95% CI) | Death attributable to CKD % (95% CI) | GDP (PPP), ($ billion) | Govt spending per person (US$ 2021) (95% CI) | Total health expenditures (% of GDP) | Annual cost KRT (US$) and out-of-pocket/% paid by patient from total cost (2021) |
||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HD | PD | KT (first year) | ||||||||||
| Global | – | 130,483,015 | 7,802,702,984 | 9.5 [5.9–11.7]a | 491.4 [359.9–636.0]a | 2.4 [1.6–3.9]a | 133.8a | – | 6.2a | 19,380.30a | 18,959.20a | 26,903.20a |
| Africa | – | 28,606,970 | 1,386,928,000 | 4.2 [3.5–5.2]a | 464.4 [389.9–528.5]a | 1.8 [1.4–2.3]a | 47.4a | – | 4.6a | 13,792.50a | 14,191.60a | 20,713.90a |
| Algeria | LMIC | 2,381,741 | 44,178,884 | 9.5 (8.9–10.2) | 560.9 (453.1–712.2) | 4.1 (3.4–5.2) | 535.8 | 142 (126–159) | 6.2 | 10,115/– | – | – |
| Angola | LMIC | 1,246,700 | 34,795,287 | 3.4 (3.1–3.7) | 325.4 (236.3–407.2) | 1.3 (1.0–1.5) | 224.0 | 24 (20–29) | 2.5 | –/0% | – | – |
| Benin | LMIC | 112,622 | 13,754,688 | 3.8 (3.5–4.1) | 483.8 (355.5–643.4) | 1.7 (1.4–2.0) | 47.4 | 7 (5–8) | 2.4 | –/0% | – | – |
| Botswana | UMIC | 581,730 | 2,384,246 | 6.1 (5.6–6.6) | 651.1 (460.3–878.3) | 2.1 (1.6–2.7) | 42.2 | 353 (326–379) | 6.1 | –/1%–25% | –/1%–25% | –/1%–25% |
| Burkina Faso | LIC | 274,200 | 21,935,389 | 3.6 (3.4–3.9) | 511.8 (403.1–634.0) | 1.4 (1.2–1.6) | 52.9 | 17 (1–20) | 5.5 | 1646/1%–25% | – | –/100% |
| Burundi | LIC | 27,830 | 12,696,478 | 3.2 (2.9–3.5) | 332.6 (258.6–420.6) | 1.3 (1.1–1.5) | 9.7 | 6 (5–7) | 8.0 | 13,793/1%–25% | – | – |
| Cabo Verde | LMIC | 4033 | 596,707 | 6.4 (5.9–6.8) | 476.7 (411.9–544.0) | 3.0 (2.7–3.3) | 3.9 | 138 (126–152) | 4.9 | –/0% | – | – |
| Cameroon | LMIC | 475,440 | 29,321,637 | 4.7 (4.4–5.0) | 636.0 (468.1–835.8) | 2.3 (1.9–2.8) | 110.6 | 3 (2–3) | 3.6 | 1724/1%–25% | – | – |
| Chad | LIC | 1,284,000 | 17,963,211 | 3.2 (2.9–3.4) | 445.1 (338.0–585.7) | 1.2 (0.9–1.5) | 26.9 | 6 (5–7) | 4.4 | – | – | –/100% |
| Congo, Democratic Republic | LIC | 2,344,858 | 108,407,721 | 3.5 (3.2–3.8) | 341.5 (271.8–421.8) | 1.4 (1.2–1.6) | 113.1 | 3 (2–3) | 3.5 | 32,538/100% | 45,571/100% | – |
| Congo, Republic | LMIC | 342,000 | 5,546,307 | 4.4 (4.0–4.7) | 456.6 (321.6–602.9) | 2.0 (1.4–2.4) | 20.7 | 19 (16–23) | 2.1 | –/>75% | –/100% | – |
| Cote d'Ivoire | LMIC | 322,463 | 28,713,423 | 4.2 (3.9–4.6) | 518.5 (385.9–661.9) | 1.9 (1.5–2.3) | 160.7 | 21 (18–24) | 3.3 | –/1%–25% | – | – |
| Djibouti | LMIC | 23,200 | 957,273 | 4.5 (4.1–4.9) | 412.8 (304.9–553.5) | 1.8 (1.5–2.1) | 6.0 | 28 (24–34) | 1.8 | – | – | – |
| Egypt | LMIC | 1,001,450 | 107,770,524 | 8.0 (7.4–8.6) | 662.4 (432.0–908.2) | 3.9 (2.5–5.3) | 1388.3 | 43 (39–48) | 4.7 | 2707/0% | 2772/– | 8318/1%–25% |
| Eritrea | LIC | 117,600 | 6,209,262 | 3.6 (3.3–3.9) | 389.8 (274.1–537.9) | 1.5 (1.1–1.9) | – | 3 (2–3) | 4.5 | – | – | – |
| Ethiopia | LIC | 1,104,300 | 113,656,596 | 3.3 (3.1–3.6) | 306.4 (268.8–349.6) | 1.8 (1.5–2.0) | 306.4 | 6 (5–7) | 3.2 | 4737/– | – | –/100% |
| Gabon | UMIC | 267,667 | 2,340,613 | 5.1 (4.7–5.5) | 628.4 (426.1–816.9) | 3.1 (2.1–3.9) | 35.5 | 158 (143–172) | 2.8 | –/1%–25% | – | – |
| Gambia | LIC | 11,300 | 2,413,403 | 4.1 (3.8–4.4) | 464.4 (358.1–592.4) | 2.3 (1.9–2.7) | 6.0 | 9 (7–10) | 3.8 | – | – | – |
| Ghana | LMIC | 238,533 | 33,107,275 | 4.6 (4.3–5.0) | 526.0 (391.0–661.3) | 2.3 (1.7–2.7) | 196.1 | 35 (29–43) | 3.4 | –/100% | – | 18,614/100% |
| Guinea | LIC | 245,857 | 13,237,832 | 3.8 (3.6–4.1) | 562.5 (437.0–718.7) | 1.7 (1.5–2.0) | 39.3 | 7 (6–8) | 4.0 | –/1%–25% | – | – |
| Kenya | LMIC | 580,367 | 55,864,655 | 3.8 (3.5–4.1) | 324.1 (274.0–380.5) | 1.6 (1.4–1.9) | 276.2 | 41 (37–45) | 4.6 | 20,254/26%–50% | 15,190/26%–50% | –/26%–50% |
| Liberia | LIC | 111,369 | 5,358,483 | 4.2 (3.9–4.5) | 488.9 (356.3–669.7) | 2.2 (1.7–2.9) | 8.1 | 9 (7–11) | 8.5 | – | – | – |
| Libya | UMIC | 1,759,540 | 7,137,931 | 9.4 (8.7–10.0) | 602.4 (443.2–774.2) | 4.3 (3.0–5.7) | 162.5 | 580 (462–711) | – | – | – | – |
| Madagascar | LIC | 587,041 | 28,172,462 | 3.5 (3.2–3.8) | 287.9 (228.6–362.7) | 1.2 (1.0–1.4) | 46.5 | 10 (8–13) | 3.7 | –/100% | – | – |
| Malawi | LIC | 118,484 | 20,794,353 | 5.3 (4.1–7.3) | 354.8 (290.6–429.0) | 1.5 (1.3–1.7) | 32.6 | 12 (10–14) | 7.4 | –/1%–25% | – | – |
| Mali | LIC | 1,240,192 | 20,741,769 | 3.5 (3.2–3.8) | 490.3 (370.7–639.2) | 1.3 (1.1–1.6) | 51.0 | 10 (9–12) | 3.9 | –/1%–25% | – | – |
| Mauritania | LMIC | 1,030,700 | 4,161,925 | 4.7 (4.4–5.1) | 454.7 (334.3–597.0) | 2.8 (2.2–3.4) | 26.9 | 23 (21-25) | 3.3 | –/1%–25% | – | – |
| Mauritius | – | – | – | 18.1 (16.8–19.4) | 2717.3 (2239.9–3272.0) | 11.8 (10.9–12.5) | – | – | – | –/0% | –/0% | –/0% |
| Morocco | LMIC | 446,550 | 36,738,229 | 9.6 (9.0–10.3) | 724.1 (574.2–881.4) | 4.1 (3.4–5.0) | 333.2 | 81 (73–89) | 5.3 | 13,901/26%–50% | 7503/1%–25% | 91,760/1%–25% |
| Mozambique | LIC | 799,380 | 31,693,239 | 3.3 (3.0–3.6) | 357.8 (279.4–441.0) | 1.0 (0.9–1.2) | 43.2 | 7 (6–9) | 7.8 | –/1%–25% | – | – |
| Namibia | UMIC | 824,292 | 2,727,409 | 5.2 (4.9–5.6) | 431.9 (311.5–583.4) | 1.9 (1.5–2.5) | 25.4 | 181 (162–201) | 8.5 | 31,014/1%–25% | 31,014/0% | –/1%–25% |
| Niger | LIC | 1,267,000 | 24,484,587 | 3.5 (3.2–3.8) | 408.2 (303.5–542.0) | 1.1 (0.9–1.3) | 32.9 | 9 (8–10) | 5.7 | –/100% | – | – |
| Nigeria | LMIC | 923,768 | 225,082,083 | 3.9 (3.6–4.2) | 357.4 (284.3–447.5) | 1.3 (1.0–1.5) | 1154.1 | 11 (9–14) | 3.0 | 23,576/100% | 29,830/– | 38,046/100% |
| Rwanda | LIC | 26,338 | 13,173,730 | 3.9 (3.5–4.2) | 348.0 (277.0–428.6) | 1.9 (1.5–2.1) | 33.1 | 18 (15–22) | 6.4 | – | – | – |
| Senegal | LMIC | 196,722 | 17,923,036 | 4.2 (3.9–4.5) | 528.5 (392.3–696.8) | 2.7 (2.2–3.4) | 64.8 | 17 (14–21) | 4.1 | 11,818/1%–25% | 13,826/1%–25% | – |
| Sierra Leone | LIC | 71,740 | 8,692,606 | 4.1 (3.8–4.4) | 490.3 (366.8–642.9) | 1.5 (1.2–1.8) | 14.9 | 9 (7–11) | 8.8 | – | – | – |
| Somalia | LIC | 637,657 | 12,386,248 | 3.0 (2.8–3.3) | 392.3 (304.6–503.6) | 1.0 (0.9–1.2) | 21.3 | 2 (1–2) | – | – | – | – |
| South Africa | UMIC | 1,219,090 | 57,516,665 | 7.3 (6.7–7.8) | 659.2 (606.8–714.6) | 2.4 (2.2–2.5) | 868.6 | 270 (245–297) | 9.1 | 15,154/100% | 8068/0% | 27,619/0% |
| Sudan | LIC | 1,861,484 | 47,958,856 | 5.6 (5.2–6.0) | 406.4 (299.7–557.8) | 2.4 (1.7–3.5) | 185.6 | 9 (7–10) | 4.6 | 4185/1%–25% | 14,557/1%–25% | 18,269/0% |
| Swaziland | LMIC | 17,364 | 1,121,761 | 5.4 (5.0–5.9) | 818.5 (580–1068.4) | 2.3 (1.9–2.7) | – | 97 (90–106) | 6.8 | –/1%–25% | –/0% | –/0% |
| Tanzania | LMIC | 947,300 | 63,852,892 | 3.6 (3.3–3.9) | 390.5 (322.6–469.3) | 1.8 (1.6–2.0) | 175.0 | 16 (13–19) | 3.8 | 31,571/>75% | – | –/>75% |
| Togo | LIC | 56,785 | 8,492,333 | 4.3 (4.0–4.6) | 479.6 (372.2–601.9) | 1.9 (1.6–2.2) | 20.2 | 9 (7–11) | 5.7 | –/51%–75% | – | –/>75% |
| Tunisia | LMIC | 163,610 | 11,896,972 | 11.8 (11.1–12.5) | 594.6 (461.0–754.8) | 3.9 (3.2–4.6) | 138.4 | 163 (147–179) | 7.0 | 6609/1%–25% | 6101/1%–25% | 20,714/1%–25% |
| Uganda | LIC | 241,038 | 46,205,893 | 3.0 (2.7–3.3) | 303.4 (232.3–381.3) | 1.4 (1.1–1.7) | 113.2 | 8 (7–10) | 3.8 | –/1%–25% | – | –/0% |
| Zambia | LIC | 752,618 | 19,642,123 | 3.5 (3.2–3.8) | 416.9 (334.5–511.9) | 1.6 (1.3–1.8) | 69.2 | 16 (13–21) | 5.3 | –/1%–25% | –/1%–25% | –/51%–75% |
| Zimbabwe | LMIC | 390,757 | 15,121,004 | 4.9 (4.5–5.3) | 520.1 (385.4–740.4) | 1.8 (1.4–2.5) | 37.2 | 13 (11–17) | 7.7 | 32,331/1%–25% | –/1%–25% | – |
–, data not reported or unavailable; CI, confidence interval; CKD, chronic kidney disease; DALY, disability-adjusted life year; GDP, gross domestic product; Govt, government; HD, hemodialysis; ISN, International Society of Nephrology; KRT, kidney replacement therapy; KT, kidney transplant; LIC, low-income country; LMIC, lower-middle-income country; PD, peritoneal dialysis; PPP, purchasing power parity; UMIC, upper-middle income country.
a
Data are presented as median [interquartile range].