Chronic kidney disease is a public health issue with significant humanitarian and
economic implications. Between 2007 and 2009, the number of patients on dialysis in
Libya increased from 2116 to 2417. It is projected that the number of patients on
dialysis will increase from 2417 in 2009 to 7667 in 2024. The proportion of patients
on peritoneal dialysis is projected to rise from 1.2% in 2014 to 16% in 2024. To maintain
a patient to dialysis machine ratio of 1: 3.4, the number of dialysis machines will
need to grow from 1045 in 2014 to 2255 in 2024. Hemodialysis units are better organized
into main and satellite units, with a potential use of mobile hemodialysis units to
deliver a local service to much smaller number of hemodialysis patients. The required
number of general nephrology beds in 2014 is estimated around 468, with 59 additional
regional transplant beds. These numbers are expected to be around 547 and 69 respectively
by 2024. Required staff to deliver service to these rising numbers of patients is
estimated to be 78 nephrologists, 9 vascular access surgeons, 4 transplant surgeons
and 4 hepatologists in 2014. The corresponding numbers in 2024 are 123, 51, 18, and
7, respectively. The number of required renal nurses in 2014 is 1767, rising to 3400
by 2024. A steady increase in the number of required transplant coordinators, histocompatibility
and immunogenetics laboratory consultants and scientists, dialysis technicians, renal
dietitians, social workers, clinical psychologists and clinical renal pharmacists
is to be expected. Recently published data showing great variability in patient mortality,
hepatitis sero-conversion rates and the lack of consistent practice to check dialysis
dose and adequacy are strong indicators for the nephrology community in Libya, the
regulatory authorities and decision makers to urgently agree national nephrology clinical
practice guidelines, and to adequately plan to train and develop the skills of the
personnel required to cope with the rising number of end stage renal disease patients.
Key-words:
End stage renal disease (ESRD) - Hemodialysis - Peritoneal dialysis - Health Care
Systems - Nephrology Care - Transplant Services.
