End-stage renal disease in sub-Saharan Africa.

End-stage renal disease (ESRD) is increasing to epidemic proportions worldwide. In most parts of sub-Saharan African, poor leadership and resultant poverty have resulted in low detection and management of ESRD. Many countries in the subregion do not have the resources, both material and manpower, to cope with the number of ESRD patients, even when detected. The Committee for the Global Advancement of Nephrology (COMGAN) and the International Society of Nephrology (ISN) site visits to the region have gone a long way to increase awareness. ISN-sponsored scholarships to doctors in the region have also served to improve the availability of needed manpower. The need to enhance preventive programs and the promotion and development of renal transplantation as an option are suggested modalities for coping with ESRD in this region.