Abstract
Chronic kidney disease (CKD) is a major global public health issue. Its treatment is financially and socially costly, particularly in the terminal stage. The objective of this study was to evaluate the costs of dialysis in patients with end-stage renal disease undergoing dialysis at the Aristide Le Dantec Hospital in Dakar. We conducted an analytical cross-sectional study with an economic focus from January 2, 2019, to June 21, 2021. A documentary review of medical records was carried out, coupled with the administration of a questionnaire to each patient meeting the inclusion criteria. Data relating to sociodemographic characteristics, epidemiology, and economics were evaluated. The database was analyzed using Epi Info version 7 software. Among the 89 patients included, 58.43% were already in the terminal stage at the time of CKD diagnosis. The initial nephropathy was dominated by vascular nephropathy, followed by CGN and CIDN, with 45.74%, 30.85%, and 10.63%, respectively. The average annual direct costs for PD patients were 1148 057 ± (792 576) CFA francs; for hemodialysis patients, these costs amounted to 1 560 417 ± (1 224 868) CFA francs. The total cost of care for all dialysis patients amounted to 1 481 922 405 CFA francs, of which 698 563 200 CFA francs (47.14%) were covered by the state and 783 359 205 CFA francs (52.86%) by the patients. The average annual cost of biological tests, travel, and special diets was statistically higher for HD patients than for other patients receiving PD (P value < 0.05). Prevention of this condition is essential in its management in order to limit or avoid its negative effects. Kidney transplantation remains a very promising alternative.
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Published in
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Science Journal of Public Health (Volume 14, Issue 2)
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DOI
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10.11648/j.sjph.20261402.15
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Page(s)
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92-104 |
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Creative Commons
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
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Copyright
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Copyright © The Author(s), 2026. Published by Science Publishing Group
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Keywords
Prevention, Cost, Dialysis, Chronic Kidney Disease
1. Introduction
Kidney disease is described as the most neglected chronic disease. While further population-based studies are needed to establish reliable estimates of the global burden of kidney disease, specific risks are present across the entire socioeconomic spectrum, affecting both poor and wealthy populations, in contexts of malnutrition as well as obesity, in agricultural and post-industrial environments, and at all ages, from newborns to the elderly
| [1] | Luyckx, V. A., M. Tonelli, et J. W. Stanifer. 2018. “The global burden of kidney disease and the sustainable development goals.” Bull World Health Organ 96, no. 6: 414-422D. |
[1]
.
Various communicable and non-communicable diseases lead to renal complications, and many individuals with kidney disease do not have access to care. The causes, consequences, and costs of kidney disease have an impact on public health policy in all countries
| [1] | Luyckx, V. A., M. Tonelli, et J. W. Stanifer. 2018. “The global burden of kidney disease and the sustainable development goals.” Bull World Health Organ 96, no. 6: 414-422D. |
[1]
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Epidemiological studies conducted worldwide estimate a prevalence ranging from 10–15%
| [2] | Chadban, S. J., E. M. Briganti, P. G. Kerr, D. W. Dunstan, T. A. Welborn, P. Z. Zimmet, et al. 2003. “Prevalence of Kidney Damage in Australian Adults. The AusDiab Kidney Study.” JASN 14, no 2: S131-8. |
[2]
. According to the International Society of Nephrology, 850 million people are affected by chronic kidney disease (CKD), 2 million are on dialysis, while 5 million should be receiving dialysis. In sub-Saharan Africa, hospital prevalence is estimated at 7.5% according to a study conducted by Outtara
| [3] | Ouattara, B., O. Kra, H. Yao, K. Kadjo and E. K. Niamkey. 2011. “Characteristics of Chronic Kidney Disease among Black Adult Patients Hospitalized in the Internal Medicine Department of Treichville University Hospital.” 7, no. 7: 531-4. |
[3]
. In Senegal, prevalence is estimated at 4.9%. According to available statistics, approximately 753 patients undergo dialysis each year, with two to three sessions per week, in public health facilities, and more than 200 patients in private health facilities. In 2019, the number of patients undergoing dialysis in public health facilities increased to 842, including 50 patients on peritoneal dialysis
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The treatment of patients reaching stage 5 chronic kidney disease is financially and socially costly and requires a significant medical effort.
Free dialysis was implemented in 2012, with a government subsidy of 910 000 000 CFA francs, which nearly tripled in 2013 to reach 2,745,600,000 CFA francs. This free dialysis policy mainly covers consumables, which are supplied to all dialysis centers in the form of kits by the National Pharmacy Supply Agency (Pharmacie Nationale d’Approvisionnement – PNA), including accredited private centers
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To improve the management of kidney diseases and support patients, significant measures have been taken by the Government of Senegal since 2012.
It is within this context that the objective of this study is to assess the costs of managing end-stage renal disease among dialysis patients at Aristide Le Dantec Hospital (HALD).
2. Methodology
2.1. Study Setting
The study was conducted in the Department of Nephrology, Dialysis, and Kidney Transplantation of Aristide Le Dantec Hospital (HALD) in Dakar, a public health facility and a national level III referral hospital. The hospital receives a heterogeneous population representing the different social strata of Senegal as well as patients from the sub-region.
The Nephrology Department of HALD includes inpatient wards with a capacity of 13 beds, two hemodialysis units, and one peritoneal dialysis unit. The first hemodialysis unit is equipped with 17 machines, including 14 functional stations and 3 backup machines, staffed by 6 senior technicians and 6 nurses divided into two teams. The second unit, commonly referred to as the “annex,” has 13 machines, including 10 functional stations and 3 backup machines, with a technical staff composed of 4 senior technicians and 4 nurses divided into two teams.
In each hemodialysis unit, two dialysis shifts are performed from Monday to Saturday, with two patient groups:
Group 1 Dialysis on Mondays, Wednesdays, and Fridays, with three 4-hour sessions per week;
Group 2 Dialysis on Tuesdays, Thursdays, and Saturdays, with 4-hour sessions per week.
Each group is further divided into two subgroups: a morning shift and an evening shift.
2.2. Type and Period of Study
This was an analytical cross-sectional study with an economic focus, conducted from January 2, 2019 to December 31, 2019.
2.3. Study Population
2.3.1. Inclusion Criteria
Patients with end-stage renal disease (ESRD) who were regularly undergoing dialysis at HALD in Dakar for at least one year during 2019 and who had a complete medical record.
2.3.2. Exclusion Criteria
Patients undergoing dialysis who refused to participate in the survey or whose health condition did not allow them to respond to the questionnaire (coma, severe illness).
Patients with incomplete or missing medical records were also excluded.
2.4. Recruitment
An exhaustive recruitment of all patients meeting the inclusion criteria was carried out.
2.5. Data Collection Technique and Tools
2.5.1. Technique
A documentary review of medical records was conducted, combined with face-to-face interviews with each patient who met the inclusion criteria.
2.5.2. Tools
A standardized data collection form was designed to collect sociodemographic and clinical data. Additional information was obtained through interviews to collect socio-professional and economic data related to the cost of care.
The data collection form included the following variables.
2.6. Variables
2.6.1. Sociodemographic Data
Patient identification (name, first name, age, sex, occupation, marital status, level of education).
2.6.2. Clinical Data
1) Stade of renal failure at diagnosis;
2) Type of dialysis;
3) Date of initiation of dialysis sessions;
4) Etiology of chronic kidney disease (CKD) and/or initial nephropathy;
5) Investigations performed during the study period.
The interview allowed us to collect the following data.
2.6.3. Disease History Data
First point of care sought after symptom onset;
Time elapsed before the diagnosis of CKD;
Place of diagnosis.
2.6.4. Economic Data
The episode of care covered a 12 months period, from January to December 2019. The direct cost of ESRD management and its complications included the following components:
(i). Direct Medical Costs
1) Annual expenses related to follow-up laboratory tests and their source of financing;
2) Annual expenses related to follow-up radiological examinations and their source of financing;
3) Annual expenses related to hospitalization costs and their source of financing;
4) Annual expenses related to medication purchases and their source of financing;
5) Annual expenses related to surgery following ESRD-related complications and their source of financing;
6) Annual expenses related to consultations in other medical and surgical specialties for the management of ESRD complications and their source of financing.
(ii). Direct Non-medical Costs
1) Annual expenses related to transportation and food, and their source of financing;
2) Annual expenses related to prescribed dietary regimens and their source of financing.
3) Indirect costs: corresponding to loss of income, calculated by comparing annual income before illness with annual income after illness; then the difference was used to assess the economic impact of ESRD on patients in terms of income.
4) Income gap = income during illness – income before illness.
5) Productivity loss cost = annual income before illness – current annual income during illness.
6) According to the Household Economy Analysis (HEA) reference profile for Senegal in 2017, an annual income below 769 450 CFA francs was considered low income, while an annual income between 769 450 and 1 388 100 CFA francs was considered middle income.
2.7. Data Entry and Analysis
Data were entered and analyzed using Microsoft Excel. Statistical analysis was performed using Epi Info version 7.
Data analysis comprised two components: descriptive and analytical.
The descriptive analysis involved calculating means, medians, ranges, and standard deviations for quantitative variables, and frequencies for qualitative variables.
Cost calculation:
Unit costs for laboratory and radiological tests were obtained from the HALD hospital tariff management system.
Medication costs were derived from prescribed medical prescriptions.
Nephrology consultations were not billed to patients, as they were conducted during dialysis sessions, which are covered by Universal Health Coverage (UHC).
Hospitalization costs were calculated by multiplying the number of hospital days by 5 000 CFA francs or 10 000 CFA francs, depending on the type of room occupied, with the addition of pharmacy costs (solutions and consumables).
Annual food costs during dialysis sessions were calculated as the average amount spent per session multiplied by the number of dialysis sessions per year for hemodialysis patients (or by the number of annual visits for peritoneal dialysis patients).
Annual transportation costs were calculated as the cost per trip multiplied by the number of trips per year.
Annual costs of consultations in other specialties for ESRD complications were calculated as the consultation fee (public or private) multiplied by the number of consultations per year Annual laboratory costs were calculated as = ∑ (unit cost × number of laboratory tests performed per year).
Annualradiologicalcostswerecalculatedas=∑(unitcost×numberofradiologicalexaminationsperformedperyear).
Annualmedicationcostswerecalculatedas=∑(unitprice×numberofmedicationspurchasedperyear).
Totalannualdirectcost=∑(annualcostsoftransportation+medications+laboratorytests+radiology+consultations+hospitalization).
Meanannualdirectcost=totalannualdirectcostforallpatients/numberofpatients.
The analytical analysis involved calculating the costs of care for dialysis patients and comparing mean costs by expenditure category between hemodialysis patients and those undergoing peritoneal dialysis using Student’s t test.
The level of statistical significance was set at 0.05.
Total annual expenditures were calculated by summing direct costs, indirect costs, and costs borne by the State.
2.8. Ethical Considerations
Written informed consent was obtained from all study participants. The purpose and objectives of the study were clearly explained to them. Participants were assured of strict confidentiality of all data and anonymity. For patients under 18 years of age, a legal guardian was designated to provide consent and complete the questionnaire.
3. Results
A total of 89 patients were enrolled in the study.
3.1. Descriptive Results
3.1.1. Socio-Professional Characteristic
Table 1. Distribution of patient’s characteristics.
Sociodemographic characteristics | Number (N=89) | Percentage (%) | Mean |
Age (in years) | | | |
<20 | 2 | 2 | |
20-29 | 7 | 8 | 83±13.40 years |
30-39 | 15 | 17 | |
40-49 | 25 | 28 | |
50-59 | 21 | 24 | |
> 60 | 19 | 21 | |
Gender: | | | |
Male | 43 | 48.04 | Sex ratio = 0.92 |
Female | 57 | 51.96 |
Marital status: | | | |
Married | 63 | 71.26 | |
Single | 19 | 20.69 | |
Divorced | 3 | 3.45 | |
Widowed | 4 | 4.60 | |
Professional: | | | |
Informal sector | 44 | 44.44 | |
No professional activity | 37 | 37.37 | |
Formal sector | 12 | 12.12 | |
Student | 6 | 6.06 | |
Health insurance coverage: | | | |
Private health insurance | 11 | 12.64% | |
Mutual health organizations | 0 | 0 | |
No health insurance | 78 | 87.36% | |
3.1.2. Clinical Data
(i). Place of Diagnosis
Diagnosis was made at HALD in 45.45% of cases, in other public health facilities in 42.05%, and in private health facilities in 12.50%.
(ii). Stage of Renal Failure at Diagnosis
The stage of renal failure at diagnosis was documented for all patients. More than half of the patients (58.43%; n = 52) were already at the end stage of chronic kidney disease (CKD) at the time of diagnosis.
(iii). Time to Diagnosis of Renal Failure
Nearly half of the patients (45.24%) experienced a diagnostic delay of more than three months. Diagnosis was established within two months in 45.24% of cases, while 9.52% were diagnosed after more than two months.
(iv). Type of Dialysis
In the study sample, 72.55% of patients were undergoing hemodialysis (HD), while 27.45% were on peritoneal dialysis.
(v). Duration on Dialysis
The mean duration of dialysis was 6.57 ± 3.93 years, with extremes ranging from 0 to 16 years. The mode and median were 7 and 6 years, respectively. Most patients had been on dialysis for 5–9 years (43,43%).
(vi). Number of Dialysis Sessions per Month
The overall mean monthly number of dialysis sessions was 35.45 ± 42.75, with a range of 9 to 120 sessions per month. The mode was 13 sessions per month.
For peritoneal dialysis, the mean monthly number of sessions was 108 ± 26.73, with extremes of 30 and 120 sessions per month; the mode was 120 sessions.
For hemodialysis, the mean monthly number of sessions was 12.8 ± 0.98, ranging from 9 to 16 sessions per month; the mode was 13 sessions.
(vii). Duration of Dialysis Sessions
The duration of the most recent dialysis session, including travel and waiting time, was documented for 81 patients. The mean duration was 5.1 ± 2.79 hours, with extremes of 0.25 and 12 hours.
(viii). First Request for Care Since the Appearance of the First Symptoms
Hospitals were the first point of care for 39.02% of patients, followed by traditional medicine (28.05%), health centers (25.61%), and private clinics (7.32%).
3.1.3. Economic Data
(i). Annual Income of Dialysis Patients
Annual income from professional activities was reported by 73 patients. The mean income was 2,671,561 ± 6,224,909 CFA francs, with a median of 960,000 CFA francs and a mode of 0 CFA francs. Values ranged from 0 to 36,000,000 CFA francs.
(ii). Direct Medical Costs
Hospitalization data were available for 85 patients. Among them, 16.47% (n = 14) had been hospitalized due to ESRD or its complications, including 10 patients on peritoneal dialysis and 4 on hemodialysis.
The mean number of hospitalizations among PD patients was 1.2 ± 0.42, with a range of 1 to 2 hospitalizations. All HD patients were hospitalized once. More than three-quarters of hospitalized patients (n = 11) had been hospitalized once, while n = 3 had been hospitalized twice.
The mean hospitalization cost related to ESRD or its complications was 136,071 ± 92,136 CFA francs, with extremes of 0 and 250,000 CFA francs. The mode and median were 150,000 CFA francs and 0 CFA francs, respectively.
Surgery Costs Related to ESRD or its complications
Information on surgical history related to ESRD was available for 29 patients. Among them, 20.69% (n = 6) had undergone surgery, while 20.69% (n = 6) were awaiting surgical intervention.
Among patients who underwent surgery, four were on PD and two on HD. Among those awaiting surgery, five were on peritoneal dialysis and one on hemodialysis.
The types of surgery included six parathyroidectomies, two central venous catheter placements, and two arteriovenous fistula creations.
Surgical costs were reported for six patients, with a mean cost of 316,666 ± 443,471 CFA francs, ranging from 0 to 1,200,000 CFA francs.
Medication costs
Prescription costs were reported for 81 patients. The mean annual medication cost was 739,400 ± 813,233 CFA francs, with extremes ranging from 0 to 3,600,000 CFA francs. The mode and median were 300,000 and 420,000 CFA francs, respectively.
Radiological investigations
The mean number of follow-up radiological examinations was 1.15 ± 1.52 per year, with a range of 0 to 18 examinations. The mode and median were 0 and 2 examinations per year, respectively.
The mean monthly cost of radiological investigations was 3,469 ± 5,210 CFA francs, with extremes of 0 and 40,000 CFA francs. The mode and median were respectively 0 and 1666 CFA francs per month.
Biological investigations
The mean number of follow-up laboratory tests was 5.4 ± 4.5 per year, with a range of 0 to 28 tests. The mode and median were 6 and 8 tests per year, respectively. The mean annual cost of laboratory tests was 151,707 ± 125,362 CFA francs, ranging from 0 to 588,000 CFA francs. The mode and median were respectively 15,999 and 121,999 CFA francs per year.
Annual number of medical follow-up visits related to CKD or its complications
The number of semiannual follow-up visits related to ESRD or its complications was reported for 81 patients. The mean was 0.4 ± 0.8 visits per semester, with a range of 0 to 4 visits.
Overall, 21 patients (25.9%) had attended follow-up visits, mainly in otorhinolaryngology (ENT) (63.16%).
The mean annual cost of follow-up consultations was 17,761 ± 21,771 CFA francs, with extremes of 0 and 80,000 CFA francs. The mode and median were 10,000 CFA francs.
Direct medical costs were distributed as follows according to the type of dialysis and the expenditure item.
Table 2. Direct medical costs by type of dialysis.
Variables | Peritoneal dialysis | Hemodialysis |
DIRECT MEDICAL COSTS | Mean | SD | Mean | SD |
Annual cost of biological assessments | 100,528 | 80264 | 171338 | 134172 |
Annual cost of radiological assessments | 53363 | 32533 | 73838 | 73158 |
Annual cost of hospitalization fees | 143000 | 102447 | 118750 | 68844 |
Annual cost of medicines | 617750 | 593746 | 790621 | 889370 |
Annual cost of surgery | 100000 | 70710 | 750000 | 636396 |
Cost spent during hospitalizations linked to CKD or its complications | 143000 | 102447 | 118750 | 68844 |
Annual cost of other consultations medico-surgical specialties for management of a complication of CKD | 10714 | 4498 | 21285 | 26072 |
(iii). Direct Non-Medical Costs
Annual transportation cost
The mean transportation cost per dialysis session was 36,603 ± 39,175 CFA francs, ranging from 1,500 to 260,000 CFA francs. The mode and median were respectively 32,500 and 26,000 CFA francs.
Annual cost of food and beverages during the last dialysis session
The mean cost of food and beverages during the last dialysis session was 745 ± 690 CFA francs, with extremes of 0 and 3,000 CFA francs. The mode and median were respectively 0 and 600 CFA francs.
Special diet prescribed by nursing staff
The notion of a special diet was reported in 87 patients; more than half of the latter, 64.37% (n=56) were on a special diet prescribed by the nursing staff.
The special diet cost was 326,900 ± 281,015 CFA francs with extremes of 0 and 1,092,000 CFA francs. The mode and median were respectively 0 and 312,000 CFA francs.
All of these direct costs are distributed as follows according to the type of dialysis and the expenditure item.
Total direct costs
The total direct cost was 1,848,503±1,133,242 CFA francs with extremes of 22,999 and 5,226,001 CFA francs. The mean and the mode were respectively 475,999 CFA francs and 1,267,999 CFA francs.
(iv). Indirect Costs: Annual Productivity Loss
The productivity loss was calculated for 50 patients. Its mean value was 3,364,920 ± 6,693,232 CFA francs with extremes ranging from 0 to 36,000,000 CFA francs. The mode was 0 and the median 1 was 140000 CFA francs.
(v). Costs Covered by the State
Since 2015, the national pharmacy supply (NPS) has billed the National Agency for Universal Health Coverage 44,000 CFA francs per hemodialysis kit. This price includes the cost of purchasing the kit by the NPS and the margins applied by the latter. In addition to this amount, the agency reimburses hospitals a flat fee of 10 000 francs per session.
For peritoneal dialysis, the cost of cassettes and solutions amounted to 4,780 CFA francs per session.
(vi). Total Costs of Care
The total cost of care for hemodialysis patients amounted to 1,136,580,121 CFA francs, of which 45.21% (513,864,000 CFA francs) was covered by the State and 54.78% (1,136,580,121 CFA francs) by patients and their families.
Table 3. Distribution of costs of caring for hemodialysis patients according to funding sources.
Type of costs | Costs | Funding source |
Patients and / or families | State |
Amount (%) | Amount (%) |
Direct medical costs | 638,583,502 | 124,719,502 (19,53) | 513,864,000 (80,47) |
Direct no medical costs | 151,416,823 | 151,416,823 (100) | 0 (0) |
Indirect costs | 346,579,796 | 346,579,796 (100) | 0 (0) |
Total Costs | 1,136,580,121 | 10,208,461 (54,78) | 513,864,000 (45,21) |
For peritoneal dialysis patients, the total cost was 345,342,284 CFA francs, with 53.5% (184,699,200 CFA francs) covered by the State and 46.5% (160,643,084 CFA francs) by patient (
Table 4).
Table 4. Distribution of caring costs for patients on peritoneal dialysis by funding sources.
Type of costs | Amount | Funding sources |
Patients and / or families | State |
Amount (%) | Amount (%) |
Direct medical costs | 217,413,140 | 32,713,940 (15%) | 184,699,200 (85%) |
Non-medical direct costs | 19,044,144 | 19,044,144 (100) | 0 (0) |
Indirect costs | 108,885,000 | 108,885,000 (100) | 0 (0) |
Total Costs | 345,342,284 | 160,64,084 (46,5%) | 184,699,200 (53,5%) |
The total cost of care for all dialysis patients was 1,481,922,405 CFA francs, of which 47.14% (698.563.200 CFA francs) was covered by the State and 52.86% (783,359,205 CFA francs) by patients and their families (
Table 5).
Table 5. Distribution of caring costs for patients on dialysis by funding sources.
Type | Amount | Funding source |
Patients and / or families | State |
Amount (%) | Amount (%) |
Direct medical costs | 855,996,642 | 157,433,442 (18,39) | 698,563,200 (81,61%) |
Non-medical direct costs | 170,460,967 | 170,460,967 (100) | 0 (0) |
Indirect costs | 455,464,796 | 455,464,796 (100) | 0 (0) |
Total Costs | 1,481,922,405 | 783,359,205 (52,86) | 698,563,200 (47,14%) |
3.2. Analytical Results
The mean annual cost of biological investigations was significantly higher among hemodialysis patients compared with those on peritoneal dialysis (p value < 0.05).
Annual transportation and meal costs during dialysis sessions were significantly higher among hemodialysis patients (p value < 0,001).
The annual cost of prescribed special diets was significantly higher among peritoneal dialysis patients compared with hemodialysis patients (p value = 0.003).
Table 6. Comparative distribution of direct costs between hemodialysis and peritoneal dialysis patients.
Variables | Dialyse péritonéale | Hémodialyse | P value |
Moyenne | ±Ecart type | Moyenne | ±Ecart type |
COÛTS DIRECTS MEDICAUX |
Coût annuel des bilans biologiques | 100528 | 80264 | 171338 | 134172 | 0,012 |
Coût annuel bilans radiologiques | 53363 | 32533 | 73838 | 73158 | 0,6 |
Coût annuel des frais d’hospitalisation | 143000 | 102447 | 118750 | 68844 | 0,569 |
Coût annuel des médicaments | 617750 | 593746 | 790621 | 889370 | 0,955 |
Coût annuel de la chirurgie au décours d’une complication de l’IRC | 100000 | 70710 | 750000 | 636396 | 0,063 |
Coût dépensé lors des hospitalisations liées à l’IRC ou de ses complications | 143000 | 102447 | 118750 | 68844 | 0,569 |
Coût annuel consultations d’autres spécialités médicochirurgicales pour PEC d’une complication de l’IRC | 10714 | 4498 | 21285 | 26072 | 0,619 |
COÛTS DIRECTS NON MEDICAUX |
Coût annuel des déplacements | 181636 | 222375 | 530653 | 501247 | <0,001 |
Coût annuel restauration hospitalière lors des séances de dialyse | 4512 | 7050 | 138540 | 105858 | <0,001 |
Coût annuel les dépenses annuelles liées aux régimes alimentaires prescrits par le soignant | 494000 | 271862 | 252633 | 254866 | 0,003 |
Coût direct total | 1848503 | 792576 | 4526825 | 1224868 | 0,187 |
COÛTS INDIRECTS | | | | | |
Coûts de perte de productivité | 3888750 | 8654244 | 3118411 | 5681636 | 0,252 |
4. Discussion
4.1. Limitations of the Study
This study was conducted during the SARS-CoV-2 pandemic in Senegal. Data collection was carried out through mobile phone interviews with patients, and supporting receipts for the reported expenses were not always available.
Moreover, the dialysis center has limited capacity due to the small number of hemodialysis beds available. According to our study, access to hemodialysis requires an average waiting period of 13 to 19 months. Many patients are therefore placed on waiting lists and are compelled to seek dialysis sessions in private facilities if they do not meet the eligibility criteria for home-based peritoneal dialysis. This situation may have influenced our results. A study including both public and private dialysis patients would provide a more accurate estimate of the economic cost of end-stage chronic kidney disease (CKD). In addition, incorporating costs related to the quality of life of dialysis patients would have allowed a more comprehensive assessment of the economic burden of end-stage renal disease (ESRD) within the community.
Regarding costs borne by the government, data related to the construction and operational costs of dialysis centers could not be collected.
Despite these limitations, the results obtained enabled the following discussions.
4.2. Socio-Economic Data
4.2.1. Age
In our study, patients aged 35–49 years (37%) and 50–64 years (36%) were the most represented. The average age was 47.83 years, comparable to that reported by Cisse and al
| [5] | Niang, A., M. Faye, A. T. Ould Lemrabott, M. Faye, S. M. Seck, M. M. Cisse, E. H. F. Ka, and B. Diouf. 2016. “Evaluation of cardiac complications among chronic hemodialysis in Dakar.” Pan Afr Med J 23, no. 1: 43-43. |
[5]
. in Dakar, Seck and al. in Saint-Louis (2014)
| [6] | Seck, S., F. Ka, and M. Cisse. 2014. “Prevalence survey of chronic kidney disease in the northern region of Senegal.” Nephrology & Therapeutics 10, no. 5: 399. |
[6]
. Falodia et al. in India
| [7] | Falodia, J., and M. K. Singla. 2012. “CKD epidemiology and risk factors.” Clinical Queries: Nephrology 1, no. 4: 249-52. |
[7]
, and Ramilitiana and al.
| [8] | Ramilitiana, B., E. M. Ranivoharisoa, M. Dodo, E. Razafimandimby, and W. F. Randriamarotia. 2016. “A Retrospective Study on the Incidence of Chronic Kidney Disease in the Internal Medicine and Nephrology Department of the University Hospital of Antananarivo.” Pan African Medical Journal 23, no. 1: 141. |
[8]
in Madagascar, with respective mean ages of 52, 47.9, 50, and 45.44 years.
In contrast, Kane and al. reported a lower mean age of 41.3 years (range: 12–72 years)
| [9] | Kane, K., M. M. M. Leye, Z. M. M. Tondi, A. L. Tall, M. Faye, M. M. Cisse, et al. 2016. “Decentralization of Dialysis in Senegal: One-Year Experience of the Tambacounda Center in Eastern Senegal.” European Scientific Journal (ESJ) 12, no. 36: 164. |
[9]
in Tambacounda, located in the East part of the country, where access to healthcare services is limited and therapeutic pathways differ from those in Dakar, particularly due to the frequent use of traditional herbal medicine before hospital consultation.
However, studies conducted in developed countries reported higher mean ages, notably in the United Kingdom (58.2 years)
| [10] | Bello, A. K., J. Peters, J. Rigby, A. A. Rahman, M. E. Nahas. 2008. “Socioeconomic Status and Chronic Kidney Disease at Presentation to a Renal Service in the United Kingdom.” Clinical Journal of the American Society of Nephrology (CJASN) 3, no. 5: 1316-23. |
[10]
, the United States (54.3 years)
| [11] | Bruce, M. A., B. M. Beech, E. D. Crook, M. Sims, S. B. Wyatt, M. F. Flessner, et al. 2010. “Association of Socioeconomic Status and CKD Among African Americans.”The Jackson Heart Study. 55, no. 6: 1001-8. |
[11]
, and France, where a study on stage 5 CKD reported a mean age of 76 years
| [12] | Loos-Ayav, C., S. Briançon, L. Frimat, J-L. Andre, M. Kessler. 2009. “Incidence of Chronic Kidney Disease in the General Population: The EPIRAN Study.” Nephrology & Therapeutics 5, no. 1: S250-5. |
[12]
. This difference may be explained by population aging, improved global health conditions, and increased life expectancy in developed countries. Being aware of the age of CKD in the general population of Senegal is mandatory for defining appropriate targerted strategies for the management of these risk factors and progression of renal diseases
| [13] | Maria Faye, Ahmed Tall Lemrabott, Mouhamadou Moustapha Cissé 1 et al. 2017. Prevalence and risk factors of chronic kidney disease in an african semi-urban area: Results from a cross-sectional survey in Gueoul, Senegal. Saudi J Kidney Dis Transpl. 28 no 6: 1389-1396. |
[13]
.
4.2.2. Gender
Females represented the majority of patients (51.96%, n = 53), while males accounted for 48.04% (n = 49), with a sex ratio of 0.92 in favor of women. This finding is comparable to that of Kane and al. in Saint-Louis, who reported a sex ratio of 0.85 (32F/27H)
| [9] | Kane, K., M. M. M. Leye, Z. M. M. Tondi, A. L. Tall, M. Faye, M. M. Cisse, et al. 2016. “Decentralization of Dialysis in Senegal: One-Year Experience of the Tambacounda Center in Eastern Senegal.” European Scientific Journal (ESJ) 12, no. 36: 164. |
[9]
. Conversely, Cisse et al. (2016) and Ramilitiana and al. (2016) reported a male predominance, with sex ratios of 1.53
| [5] | Niang, A., M. Faye, A. T. Ould Lemrabott, M. Faye, S. M. Seck, M. M. Cisse, E. H. F. Ka, and B. Diouf. 2016. “Evaluation of cardiac complications among chronic hemodialysis in Dakar.” Pan Afr Med J 23, no. 1: 43-43. |
[5]
and 1.46
| [8] | Ramilitiana, B., E. M. Ranivoharisoa, M. Dodo, E. Razafimandimby, and W. F. Randriamarotia. 2016. “A Retrospective Study on the Incidence of Chronic Kidney Disease in the Internal Medicine and Nephrology Department of the University Hospital of Antananarivo.” Pan African Medical Journal 23, no. 1: 141. |
[8]
, respectively.
This female predominance may be explained by the increasing prevalence of cardiovascular risk factors in the Senegalese population (13), particularly among women, including physical inactivity, obesity, and hypercholesterolemia.
This observation is consistent with the high morbidity and the substantial socio-professional burden associated with long-term dialysis. In our study:
1) Seven out of ten patients (72.55%) were on hemodialysis;
2) The average duration of a dialysis session, including travel and waiting time, was 5.1 ± 2.79 hours;
3) The average number of hemodialysis sessions per month was 12.8 ± 0.98 (range: 9–16);
4) The mean duration on dialysis was 6.57 ± 3.93 years (range: 0–16 years), with most patients having been on dialysis for 5–9 years (43.43%).
4.2.3. Educational Level
More than half of the patients (60.68%) were educated, predominantly at the secondary level (30.34%). This contrasts with findings from studies conducted in Congo
| [14] | A., K. Babaka, A. A. Ngaïde, M. Gazal, M. Faye, K. Niang, et al. 2018. “Prevalence of Cardiovascular Risk Factors in a Semi-Rural Area of Senegal.” Annals of Cardiology and Angiology 67, no. 4: 264-9. |
[14]
, Rabat (Morocco)
| [15] | Sumaili, E. K., E. P. Cohen, C. V. Zinga, J-M. Krzesinski, N. M. Pakasa, and N. M. Nseka. 2009. “High prevalence of undiagnosed chronic kidney disease among at-risk population in Kinshasa, the Democratic Republic of Congo.” BMC Nephrology 10, no. 1: 18. |
[15]
, northern Senegal (2012)
| [16] | Farouki, M. E., A. Bahadi, M. A. Hamzi, D. Kabbaj, M. Benyahia. 2013. “Profil des insuffisants renaux chroniques diabetiques à l’initiation de l’hemodialyse au service de nephrologie et dialyse de l’hôpital militaire de Rabat, Maroc.” Pan African Medical Journal 15, no. 1: 1-5. |
[16]
, and rural Haiti
| [17] | Seck, S. M., D. Doupa, L. Gueye, C. A. Dia. 2014. “Epidemiology of chronic kidney disease in northern region of Senegal: a communitybased study in 2012.” Pan African Medical Journal 18, no 1: 1-8. |
[17]
, where most patients had fewer than six years of formal education.
In our case, this difference may be explained by the urban setting of the study, which limits access for a large portion of the population and suggests that the study population may not accurately reflect the overall educational profile of Senegalese society.
4.2.4. Income and Social Coverage
The income level of household heads is a key determinant of households’ ability to finance healthcare. Annual income was reported for 73 patients, with a mean of 2,671,561 CFA francs, considered relatively high as it exceeds 2,234,500 CFA francs per year.
In 2022, the annual disposable income per capita in Senegal was estimated at 712,342 FCFA, with significant disparities depending on socio-economic status. However, insurance coverage data were available for 87 patients, among whom 87.36% did not have health insurance. These findings are consistent with the results of this study, which showed that more than 44% of patients were employed in the formal sector
| [18] | Burkhalter, F., H. Sannon, M. Mayr, M. Dickenmann, S. Ernst. 2014. “Prevalence and risk factors for chronic kidney disease in a rural region of Haiti.” Swiss Medical Weekly.; 144, no 5152: 1-5. |
[18]
.
4.3. Epidemiological Data
4.3.1. Place of Diagnosis
A total of 45.45% of patients were diagnosed at HALD, 42.05% in other public healthcare facilities, and 12.50% in private facilities. The nephrology department of HALD is the only university hospital nephrology unit in Senegal and hosts the country’s only peritoneal dialysis service. It serves as a national referral center, with 54.55% of dialysis patients referred from other facilities, and plays a key diagnostic role.
4.3.2. Stage of Disease at Diagnosis
At the time of the first nephrology consultation, more than half of the patients (58.43%, n = 52) were already at the terminal stage of CKD. Similar findings have been reported in most low- and middle-income countries, including Morocco (15), Senegal (2012)
| [16] | Farouki, M. E., A. Bahadi, M. A. Hamzi, D. Kabbaj, M. Benyahia. 2013. “Profil des insuffisants renaux chroniques diabetiques à l’initiation de l’hemodialyse au service de nephrologie et dialyse de l’hôpital militaire de Rabat, Maroc.” Pan African Medical Journal 15, no. 1: 1-5. |
[16]
, and Haiti
| [17] | Seck, S. M., D. Doupa, L. Gueye, C. A. Dia. 2014. “Epidemiology of chronic kidney disease in northern region of Senegal: a communitybased study in 2012.” Pan African Medical Journal 18, no 1: 1-8. |
[17]
. In contrast, studies from developed and emerging countries such as the United States
| [19] | National Agency for Statistics and Demography. 2025. “Economic and Social Situation of Senegal 2022–2023”. |
[19]
and southern China
| [20] | Coresh, J., E. Selvin, L. A. Stevens, J. Manzi, J. W. Kusek, P. Eggers, et al. 2007. “Prevalence of Chronic Kidney Disease in the United States.” JAMA 298, no. 17: 2038-47. |
[20]
, report that fewer than 50% of patients are diagnosed at stages above stage 3.
This situation is attributable to inadequate screening policies, limited awareness of CKD among general practitioners, financial constraints, and lack of health insurance. Patients with chronic conditions such as diabetes and hypertension often delay medical consultation, resorting instead to alternatives such as prayer and traditional herbal medicine. In our study, 28.05% of patients reported using traditional medicine before seeking hospital care. These factors contribute to diagnostic delay and therapeutic wandering.
4.3.3. Initial Nephropathy
The most frequent initial nephropathy was vascular nephropathy (45.74%), followed by chronic glomerulonephritis (30.85%) and chronic tubulointerstitial nephropathy (10.63%). These findings are consistent with those reported by Cisse and al. in Dakar (2016)
| [5] | Niang, A., M. Faye, A. T. Ould Lemrabott, M. Faye, S. M. Seck, M. M. Cisse, E. H. F. Ka, and B. Diouf. 2016. “Evaluation of cardiac complications among chronic hemodialysis in Dakar.” Pan Afr Med J 23, no. 1: 43-43. |
[5]
where nephroangiosclerosis was the leading cause, followed by diabetic nephropathy.
However, this predominance of vascular nephropathy differs from reports in the broader literature. In Tunisia, Chargui and al. (2020) found that glomerular nephropathy was predominant (37.5%), followed by vascular nephropathy (31.81%). In Morocco, El Bardai et al. (2013)
| [21] | Chen, W., W. Chen, H. Wang, X. Dong, Q. Liu, H. Mao, et al. 2009. “Prevalence and risk factors associated with chronic kidney disease in an adult population from southern China.” Nephrology Dialysis Transplantation 24, no. 4: 1205-12. |
[21]
, reported vascular nephropathy in only 17.2% of cases, similar to findings in Togo (17.6%) and Mali.
This strong predominance of vascular nephropathy is not found in the general literature as in Tunisia where the predominant initial nephropathy was glomerular nephropathy (37.5)% followed by vascular nephropathy (31.81) in a study carried out in 2020 by Chargui and al. In Morocco, El Bardai and Al in 2013
| [21] | Chen, W., W. Chen, H. Wang, X. Dong, Q. Liu, H. Mao, et al. 2009. “Prevalence and risk factors associated with chronic kidney disease in an adult population from southern China.” Nephrology Dialysis Transplantation 24, no. 4: 1205-12. |
[21]
found this vascular nephropathy in only 17.2%. The same as in Togo with 17.6% of vascular nephropathy by Sabi KA et al in 2011
| [22] | El Bardai, G., S. Jaafour, N. Kabbali, M. Arrayhani, and T. Sqalli Houssaini. 2013. “Is Preserving Residual Diuresis Truly Beneficial in Chronic Hemodialysis Patients ?” Nephrology & Therapeutics 9, no. 5: 294. |
[22]
. In Mali, glomerular nephropathy was 58.3%, vascular nephropathy 25.0%, undetermined nephropathy 16.7% by Coulibaly and al.
This is explained by the incidence of hypertension, obesity and other cardiovascular risk factors in Senegal and more particularly in urban areas because people from secondary towns and rural areas have significantly less risk of being affected by hypertension and being obese when they have lived in Dakar for less than ten years
| [23] | Ka, S., and G. Da. 2011. “Chronic Kidney Disease in Togo: Clinical, Paraclinical, and Etiological Aspects.” Med Trop 71, no. 1: 74-76. |
[23]
.
4.4. Economic Data
4.4.1. Direct Costs
(i). Distribution of Prescription Drug Costs
The average annual expenditure related to medical prescriptions was estimated at 739,400 CFA francs with extremes ranging from 0 to 3,600,000 CFA francs. The mode and the median were 300,000 and 420,000 CFA francs respectively. These expenses were higher among hemodialysis (HD) patients, with an annual average of 790,621 CFA francs, compared to 617,750 CFA francs per year among peritoneal dialysis (PD) patients. Thus, in principle, each dialysis patient at HALD must spend 61,616 CFA francs per month on medical prescriptions. In the event of complications, these amounts may be doubled or even tripled, depending on whether the patient presents with one or more complications.
In France, the average annual cost of medications was 5,048,005.5 FCFA for HD patients compared to 1,871,452.5 CFA francs for PD patients in 2007
| [24] | Duboz, P., E. Macia, L. Gueye, and N. Chapuis-Lucciani. 2011. “Internal Migration and Health in Dakar (Senegal): Comparison of Self-Rated Health, Hypertension, and Obesity between Internal Migrants and Native Residents of Dakar.” Bull Mem Soc Anthropol 23, no. 1: 83-93. |
[24]
.
These figures are markedly higher than our results, almost ten times greater, which can be explained by differences in health coverage systems. In France, health insurance and social security schemes facilitate access to all prescribed medications, whereas in Senegal, patients purchase medications according to their financial means, and some are forced to prioritize only the most urgent treatments.
Therefore, our figures do not necessarily reflect the actual medication needs of dialysis patients.
(ii). Distribution of Biological Monitoring Costs
The average annual cost per patient for biological follow-up tests was 151,707 CFA francs, with extremes ranging from 0 to 588,000 CFA francs. Costs were higher among HD patients, with an annual mean of 171,338 CFA francs, compared to 100,528 CFA francs among PD patients (p-value = 0.012).
These costs were again substantially higher in France, where in 2016 they amounted to 1,085,508 CFA francs per year per HD patient compared to 684,342 CFA francs per PD patient
| [25] | Benain, J. P., B. Faller, and C. Briat. 2007. “Cost of Dialysis Management in France.” Elsevier EM.: 96-106. |
[25]
.
(iii). Distribution of Radiological Examination Costs
The average annual cost of radiological follow-up examinations was 70,084 CFA francs, with extremes ranging from 0 to 480,000 CFA francs per year. The mode and the median were both 60,000 FCFA. The average cost was 73,838 CFA francs for HD patients and 53,363 CFA francs for PD patients, with no statistically significant difference (p-value = 0.6), as patients are exposed to similar osteoarticular and cardiovascular complications related to chronic kidney disease (CKD).
(iv). Distribution of Hospitalization Costs
The average annual cost of hospitalizations related to CKD or its complications was 136,071 ± 92,136 FCFA, with extremes ranging from 0 to 250,000 FCFA. Costs were slightly higher among HD patients, with an annual mean of 143,000 FCFA, compared to 118,750 FCFA among PD patients (p-value = 0.65).
These values are significantly lower than those reported in other countries, such as Algeria, where hospitalization costs reach 6,117,485.634 CFA francs (26). This difference is explained by the fact that dialysis sessions at HALD are free of charge for patients, being fully covered under Universal Health Coverage (UHC) through the Sesame plan. In contrast, in the literature, dialysis costs are often included in hospitalization expenses, as was the case in the Algerian study.
In France, hospitalization costs amount to 5,081,436 CFA francs for HD patients and 5,144,364 CFA francs for PD patients
| [25] | Benain, J. P., B. Faller, and C. Briat. 2007. “Cost of Dialysis Management in France.” Elsevier EM.: 96-106. |
[25]
.
(v). Distribution of Surgery-related Costs
Surgical costs related to CKD or its complications were reported in six patients, with an average of 316,666 ± 443,471 CFA francs, and extremes ranging from 0 to 1,200,000 CFA francs.
Comparatively, the average cost was 143,000 ± 102,447 CFA francs for PD patients and 118,750 ± 68,844 CFA francs for HD patients (p-value = 0.569). Surgical procedures differ between PD and HD patients; however, most interventions are free for dialysis patients at HALD, with patients only covering the costs of infusion solutions and resuscitation products.
Sttudy in Ethiopia revealed the annual cost of hemodialysis treatment among ESRD patients was high compared to the national per capita health expenditure, and two-thirds covered by the direct medical costs. Old age, high wealth status, more visits, anemia, and comorbidity were factors associated with the costs of hemodialysis
| [26] | Daniel Asrat Kassa 1, Solomon Mekonnen 2, Adane Kebede 1, Tsegaye Gebremedhin Haile 1. 2020. Cost of Hemodialysis Treatment and Associated Factors Among End-Stage Renal Disease Patients at the Tertiary Hospitals of Addis Ababa City and Amhara Region, Ethiopia. Clinicoecon Outcomes Res.; 2712: 399–409. |
[26]
.
(vi). Distribution of Costs for Consultations with Other Specialities
Overall, 21 patients (25.9%) attended semiannual follow-up consultations related to CKD or its complications. The specialties consulted were mainly otorhinolaryngology (ENT) (63.16%), reflecting parathyroid-related complications. Indeed, parathyroidectomy, when performed by experienced specialists, is an effective means of reducing parathyroid hormone (PTH) secretion with low morbidity and mortality in cases of secondary hyperparathyroidism refractory to medical treatment
| [27] | Zitouni, S. N., and S. Bouzid. 2020. “La parathyroïdectomie dans le traitement de l’hyperparathyroïdie secondaire chez les dialyses chroniques.” Alger J health sci (Online Oran): 14-24. |
[27]
.
The annual cost of follow-up consultations related to CKD or its complications was 17,761 CFA francs, with a mode and median of 10,000 CFA francs.
(vi). Distribution of Costs Related to Prescribed Dietary Regimens
The average cost of special dietary regimens was 326,900 CFA francs, higher among PD patients, with a mean of 494,000 CFA francs, compared to 252,633 CFA francs among HD patients (p-value = 0.003). HD patients incurred higher transportation costs due to three weekly dialysis sessions and therefore did not strictly adhere to dietary restrictions, sometimes being compelled to eat from the family pot. This situation is directly linked to out-of-pocket payments and catastrophic health expenditures.
(vii). Distribution of Transportation-related Costs
The average annual transportation cost for dialysis sessions was 439,244 FCFA. Costs were higher among HD patients, with an average of 530,653 FCFA, compared to 181,636 FCFA among PD patients (p-value < 0.001).
The average cost of food and beverages during dialysis sessions was 99,579 FCFA, again higher among HD patients (138,540 FCFA) compared to PD patients (4,512 FCFA) (p-value < 0.001). This difference is explained by the number of trips made by HD patients, averaging 13 sessions per month, whereas PD patients travel only once or twice per month to collect supplies.
Overall, these expenses are exorbitant for a study population with very low average monthly income. This is explained by the geographical location of HALD relative to patients’ residences and by the timing of the study, which was conducted during the COVID-19 pandemic, marked by nationwide transportation restrictions.
4.4.2. Indirect Costs
During our survey, we observed that patients were predominantly engaged in informal activities (44.44%), while 37.37% had no professional activity. A dialysis patient typically undergoes three iterative sessions per week, each lasting approximately four hours. The average duration of a dialysis session, including travel time, connection time, and waiting time, was 5.1 ± 2.79 hours, with extremes ranging from 0.25 to 12 hours, depending on the dialysis modality. This is largely incompatible with many formal occupations, explaining the high proportion of patients engaged in informal work.
From a medical perspective, the numerous complications arising from CKD and dialysis itself, particularly calcium-phosphate disorders leading to mobility impairment or loss, inevitably result in productivity losses due to the impact of end-stage renal disease on labor supply.
In our study, the annual productivity loss amounted to 3,888,750 CFA francs among PD patients and 3,118,411 CFA francs among HD patients, with no statistically significant difference.
This situation highlights the financial distress experienced by individuals with terminal renal failure, extending beyond the affected individual to the entire household.
Nearly all patients in our sample (95.98%) were experiencing catastrophic health expenditures, a direct consequence of out-of-pocket payments by users of the HALD dialysis center. Poor households thus face an increased risk of further impoverishment due to income loss associated with illness and its overall impact on quality of life.
5. Conclusion
Chronic kidney disease (CKD) represents a major global public health challenge. Its management is financially and socially costly, particularly at the stage of end-stage renal disease (ESRD). In light of our findings, efficient patient care requires a multidisciplinary approach involving multiple stakeholders. Preventing kidney disease at various levels within health development programs constitutes a key lever for reducing the incidence of CKD. This includes reducing risk factors through healthy lifestyle and dietary practices, avoiding self-medication and unregulated traditional treatments.
At the same time, the Ministry of Health must continue to decentralize hemodialysis centers, ensure the availability of peritoneal dialysis in all dialysis facilities, strengthen the training of nephrologists and dialysis technicians, improve population-level access to care, and effectively implement a renal transplantation program.
Abbreviations
PTH | Parathyroid Hormone |
PD | Peritoneal Dialysis |
NPS | National Pharmacy Supply |
HEA | Household Economy Analysis |
ESRD | End-Stage Renal Disease |
HALD | Aristide Le Dantec Hospital |
CKD | Chronic Kidney Disease |
UHC | Universal Health Coverage |
HD | Hemodialysis |
Author Contributions
Mbathio Diop: Conceptualization, Data curation, Formal Analysis, Methodology, Writing – original draft
Mareme Maty Dioum: Conceptualization, Data curation, Formal Analysis, Methodology, Supervision, Validation, Writing – original draft
Serigne Ndame Dieng: Conceptualization, Methodology, Writing – original draft, Writing – review & editing
Morel Fabrice Bignon Aguair: Conceptualization, Formal Analysis, Methodology, Writing – original draft, Writing – review & editing
Mamadou Makhtar Mbacke Leye: Conceptualization, Data curation, Formal Analysis, Methodology, Supervision, Validation, Writing – original draft, Writing – review & editing
Conflicts of Interest
The authors declare no conflicts of interest regarding the publication of this paper.
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Cite This Article
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APA Style
Diop, M., Dioum, M. M., Dieng, S. N., Aguair, M. F. B., Leye, M. M. M. (2026). Study of the Costs of Treating End-Stage Renal Failure in Dialysis Patients at the Aristide Le Dantec Hospital (Senegal) in 2019. Science Journal of Public Health, 14(2), 92-104. https://doi.org/10.11648/j.sjph.20261402.15
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Diop, M.; Dioum, M. M.; Dieng, S. N.; Aguair, M. F. B.; Leye, M. M. M. Study of the Costs of Treating End-Stage Renal Failure in Dialysis Patients at the Aristide Le Dantec Hospital (Senegal) in 2019. Sci. J. Public Health 2026, 14(2), 92-104. doi: 10.11648/j.sjph.20261402.15
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Diop M, Dioum MM, Dieng SN, Aguair MFB, Leye MMM. Study of the Costs of Treating End-Stage Renal Failure in Dialysis Patients at the Aristide Le Dantec Hospital (Senegal) in 2019. Sci J Public Health. 2026;14(2):92-104. doi: 10.11648/j.sjph.20261402.15
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@article{10.11648/j.sjph.20261402.15,
author = {Mbathio Diop and Mareme Maty Dioum and Serigne Ndame Dieng and Morel Fabrice Bignon Aguair and Mamadou Makhtar Mbacke Leye},
title = {Study of the Costs of Treating End-Stage Renal Failure in Dialysis Patients at the Aristide Le Dantec Hospital (Senegal) in 2019},
journal = {Science Journal of Public Health},
volume = {14},
number = {2},
pages = {92-104},
doi = {10.11648/j.sjph.20261402.15},
url = {https://doi.org/10.11648/j.sjph.20261402.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20261402.15},
abstract = {Chronic kidney disease (CKD) is a major global public health issue. Its treatment is financially and socially costly, particularly in the terminal stage. The objective of this study was to evaluate the costs of dialysis in patients with end-stage renal disease undergoing dialysis at the Aristide Le Dantec Hospital in Dakar. We conducted an analytical cross-sectional study with an economic focus from January 2, 2019, to June 21, 2021. A documentary review of medical records was carried out, coupled with the administration of a questionnaire to each patient meeting the inclusion criteria. Data relating to sociodemographic characteristics, epidemiology, and economics were evaluated. The database was analyzed using Epi Info version 7 software. Among the 89 patients included, 58.43% were already in the terminal stage at the time of CKD diagnosis. The initial nephropathy was dominated by vascular nephropathy, followed by CGN and CIDN, with 45.74%, 30.85%, and 10.63%, respectively. The average annual direct costs for PD patients were 1148 057 ± (792 576) CFA francs; for hemodialysis patients, these costs amounted to 1 560 417 ± (1 224 868) CFA francs. The total cost of care for all dialysis patients amounted to 1 481 922 405 CFA francs, of which 698 563 200 CFA francs (47.14%) were covered by the state and 783 359 205 CFA francs (52.86%) by the patients. The average annual cost of biological tests, travel, and special diets was statistically higher for HD patients than for other patients receiving PD (P value < 0.05). Prevention of this condition is essential in its management in order to limit or avoid its negative effects. Kidney transplantation remains a very promising alternative.},
year = {2026}
}
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TY - JOUR
T1 - Study of the Costs of Treating End-Stage Renal Failure in Dialysis Patients at the Aristide Le Dantec Hospital (Senegal) in 2019
AU - Mbathio Diop
AU - Mareme Maty Dioum
AU - Serigne Ndame Dieng
AU - Morel Fabrice Bignon Aguair
AU - Mamadou Makhtar Mbacke Leye
Y1 - 2026/04/20
PY - 2026
N1 - https://doi.org/10.11648/j.sjph.20261402.15
DO - 10.11648/j.sjph.20261402.15
T2 - Science Journal of Public Health
JF - Science Journal of Public Health
JO - Science Journal of Public Health
SP - 92
EP - 104
PB - Science Publishing Group
SN - 2328-7950
UR - https://doi.org/10.11648/j.sjph.20261402.15
AB - Chronic kidney disease (CKD) is a major global public health issue. Its treatment is financially and socially costly, particularly in the terminal stage. The objective of this study was to evaluate the costs of dialysis in patients with end-stage renal disease undergoing dialysis at the Aristide Le Dantec Hospital in Dakar. We conducted an analytical cross-sectional study with an economic focus from January 2, 2019, to June 21, 2021. A documentary review of medical records was carried out, coupled with the administration of a questionnaire to each patient meeting the inclusion criteria. Data relating to sociodemographic characteristics, epidemiology, and economics were evaluated. The database was analyzed using Epi Info version 7 software. Among the 89 patients included, 58.43% were already in the terminal stage at the time of CKD diagnosis. The initial nephropathy was dominated by vascular nephropathy, followed by CGN and CIDN, with 45.74%, 30.85%, and 10.63%, respectively. The average annual direct costs for PD patients were 1148 057 ± (792 576) CFA francs; for hemodialysis patients, these costs amounted to 1 560 417 ± (1 224 868) CFA francs. The total cost of care for all dialysis patients amounted to 1 481 922 405 CFA francs, of which 698 563 200 CFA francs (47.14%) were covered by the state and 783 359 205 CFA francs (52.86%) by the patients. The average annual cost of biological tests, travel, and special diets was statistically higher for HD patients than for other patients receiving PD (P value < 0.05). Prevention of this condition is essential in its management in order to limit or avoid its negative effects. Kidney transplantation remains a very promising alternative.
VL - 14
IS - 2
ER -
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