Free dialysis in Nepal: Logistical challenges explored |
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Authors: | John Mcgee Bimal Pandey Abhishek Maskey Tifany Frazer Theodore Mackinney |
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Affiliation: | 1. The Medical College of Wisconsin is a private, accredited medical school and graduate school of sciences located in Milwaukee, Wisconsin, United States;2. Patan Academy of Health Sciences is an autonomous, not‐for‐profit, public institution of higher education located in Patan, Lalitpur, Nepal;3. Manipal College of Medical Sciences is a private medical college associated with Manipal Teaching Hospital, located in Pokhara, Nepal |
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Abstract: | Nepal's Ministry of Health began offering free lifetime hemodialysis (HD) in 2016. There has been a large growth in renal replacement therapy (RRT) services offered in Nepal since 2010, when the last known data on the subject was published. In 2016, 42 HD centers existed (223% increase since 2010) serving 1975 end stage renal disease patients (303% increase since 2010); 36 nephrologists were registered (200% increase since 2010), 12 were trained in transplantation, and 790 transplants had been performed to date. We estimate the incidence of end stage renal disease to be 2900 patients (100 per million population). With an annual cost of approximately US$2300 per dialysis patient, offering free dialysis could potentially cost the government US$6.7 million per year, suggesting that 2.1% of the annual health budget would be allocated to 0.01% of the population. The geographic zone surrounding the capital city, Kathmandu, contains 50% of HD centers, but only 14.5% of Nepal's population. Forty‐eight percent of the population lives within zones without HD service, therefore infrastructure challenges exist in providing equitable access to RRT. The aim of this article is to summarize the current statistics of RRT in Nepal. |
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Keywords: | Hemodialysis Nepal renal replacement therapy renal transplantation free hemodialysis |
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