Projects

A 50-year-old man in a low-income country presented to a private sector referral hospital with edema and symptomatic uremia and was diagnosed with kidney failure. His hypertension was detected 10 years ago, but he did not pursue evaluation or treatment. Urgent hemodialysis (HD) was initiated, and the need for maintenance HD or peritoneal dialysis (PD) was discussed. The patient farmed a piece of land in a rural area, the sole earner for his family, and did not have any private health care insurance. Although eligible for government-funded public sector dialysis, the nearest center was 200 km away and offered HD but did not have a PD program. He was unable to afford the out-of-pocket costs of HD or PD in the private sector nephrology center that initiated his treatment.