The growing number of young people diagnosed with kidney disease has raised concerns about the increasing burden of chronic kidney conditions in Kenya, threatening the country's ability to manage non-communicable diseases effectively.
Although national data is limited, experts note a rise in cases among adolescents and young adults showing signs of end-stage renal disease (ESRD), despite not having the usual risk factors, such as diabetes or hypertension.
ESRD is the final, irreversible stage of chronic kidney disease, where kidney function has deteriorated to the extent that they can no longer operate independently.
Jonathan Wala, the president of the Kenya Renal Association, attributes this trend to changing lifestyles, raising questions about possible environmental, dietary, or medication-related triggers.
“We’re seeing young patients who do not present with traditional causes. While diabetes and hypertension remain the leading factors, the disease profile is shifting, and we can only speculate on the causes for now," says Dr Wala.
Kidney disease is classified as a non-communicable disease (NCD), alongside conditions such as diabetes, cancer, and heart disease. According to the World Health Organization (WHO), NCDs account for 74 percent of all global deaths, with 85 percent of premature deaths (between the ages of 30 and 69) occurring in low- and middle-income countries.
In Kenya, NCDs are a growing health concern, contributing to over 33 percent of all annual deaths, according to estimates by the Ministry of Health. Chronic kidney disease (CKD), though often underreported, is one of the fastest-growing NCDs, fueled by rising rates of diabetes, hypertension, obesity, and changing lifestyles.
Dr Wala emphasises that the true burden of kidney disease is likely underrepresented in official statistics. “The Global Burden of Disease study provides a rough estimate, but we believe that up to 10 percent of the Kenyan population may be affected by kidney disease, which equates to over five million people,” he states.
Despite this increasing burden, Kenya only has 55 nephrologists to serve a population of over 50 million, falling far short of the International Society of Nephrology recommended minimum of one nephrologist for every 250,000 people. This shortage makes it nearly impossible to provide timely, specialist-led care to all patients.
According to Dr Wala, most dialysis units are staffed by medical officers or nurses without nephrology training, limiting their ability to manage complications, perform vascular access procedures, or address comorbidities such as cardiovascular disease.
“Dialysis access is more than just the machine,” explains Dr Wala. “It’s about having trained personnel to manage the patient as a whole, covering nutrition, heart health, diabetes, blood pressure, and infection control. Without that, outcomes remain poor.”
He notes that the number of dialysis patients has stagnanted for years, not because the disease is decreasing, but because many patients are dying silently.
“We fear that for every new patient starting dialysis, another is dying,” he says. “And they often don’t die from kidney failure itself, but from heart disease or infections that we’re not managing well enough.”
Kenya is currently decentralising kidney care to address the increasing demand for treatment. In May, the Kenya University Teaching, Referral and Research Hospital launched its transplant programme, performing two surgeries. The staff received training at Apollo Hospital in India with the support of a partnership with Moi Teaching and Referral Hospital.
The Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu plans to introduce transplant services by late 2025, with support from Egypt’s Alameda Hospital. The hospital already treats over 60 patients on dialysis.
Despite significant improvements in access to dialysis, the country is facing a rising number of kidney-related deaths, putting pressure on the health system. It is estimated that four to five million Kenyans suffer from CKD, with over 12,500 requiring a kidney transplant. However, between 2012 and 2022, only about 700 kidney transplants were performed, representing less than three percent of those in need. The rest rely on dialysis, which, while significant —more than 5,000 patients are currently receiving treatment —is more expensive in the long run and results in poorer health outcomes.
Although dialysis services are covered (Sh10,650 per session)by the Social Health Authority (SHA), the pre-evaluation costs, averaging Sh200,000, and the monthly immunosuppressant medication costs, ranging from Sh30,000 to Sh60,000, remain largely uncovered.
Peritoneal dialysis is billed at approximately Sh85,600 per month, with some packages including specialist visits, laboratory tests, and anaemia management through erythropoietin injections. However, the implementation of these services remains inconsistent.
A kidney transplant in public hospitals such as Kenyatta National Hospital costs around Sh500,000 under SHA. However, including pre-evaluation and medication expenses can increase the total to around Sh1.5 million. In private hospitals, the cost can be as high as Sh2 million.
Meanwhile, policy and legal reforms are also taking shape. A bill scheduled for parliamentary debate in 2024 proposes permitting organ donation from brain-dead patients who have given prior consent, in line with the WHO standards and the Declaration of Istanbul.
The bill also suggests establishing a National Organ Donation Authority to oversee the ethical sourcing and matching of organs for transplant.
