Experience with chronic haemodialysis in Johannesburg

Since 1966 the treatment for patients with end-stage renal disease in Johannesburg has primarily been renal transplantation. This has required an adequate programme of regular dialysis. All patients were treated at the central hospital or at two small satellite units. A total of 158 patients, mean age 34,2 years (88 males) have been dialysed. The mean duration on dialysis prior to transplantation was 5,6 months (range 1 week - 23 months). The commonest cause of renal failure in males was chronic glomerulonephritis (63%), whereas in females it was analgesic nephropathy (39%). Twenty-seven patients (17%) died while on dialysis, including 6 who had had unsuccessful transplantations. Renal osteodystrophy was diagnosed in 30% of the patients. Hepatitis has been endemic among both patients and staff. Nephrectomies were done in 106 patients. Ten patients had operations for peptic ulcer and 5 parathyroidectomies were performed. The number of patients unsuccessfully transplanted, or who died, was less than the number of new patients requiring treatment. In addition, an increasing proportion of patients have become 'relatively untransplaotable'. This has led to overloading of facilities.S. Afr. Med. J., 48, 1821 (1974