A study undertaken during 2015 at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi demonstrated that 20% of general medical admissions over a three-month period had evidence of kidney disease. Outcome (hospital mortality) in these patients was significantly worse than those with normal renal function.
In response to this, and in line with the Ministry of Health’s commitment to developing specialist services within Malawi, a dedicated renal ward was opened at the end of 2015. The ward was renovated and staff training provided with the help and generosity of the Royal Free Hospital Renal Transplant Patient Association. Dedicated renal nurses and clinical officers staff the ward. Its aim is to provide excellence in clinical care and improve both patient outcome and patient experience in those suffering from kidney disease in one of the poorest areas of the world.
The ward has been fully operational now for over three months. It manages patients with Acute Kidney Injury (AKI) and advanced CKD. All adult patients with AKI that require renal replacement therapy (RRT) undergo hemodialysis (HD) in the adjacent HD unit (free at the point of delivery). We have a limited cohort of patients on chronic HD. We provide a dedicated palliative care service for the many patients with ESRD for whom resources are not available to provide RRT. We plan to report on patient outcomes and experience of the unit later in the year.
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