In Practice

Provision of long-term renal replacement therapy to non-national patients in South Africa

M Davies, Z Cassimjee

Abstract


Dialysis is a life-saving but costly therapy, which in the local context may be considered to be a constrained resource. The residual effects of South Africa (SA)’s historical inequalities and the pathophysiology of chronic kidney disease in our population result in significant demand being placed upon state dialysis units, which consequently are forced to ration access to treatment. Although such rationing is undertaken with due regard to local and international protocols, state units have been subject to legal challenge. Consequently, jurisprudence relevant to the provision of dialysis and other similarly resource-constrained therapies has evolved. In this article, we discuss a recent case that led to a landmark ruling on the access of non-SA nationals to dialysis, contextualised against existing guidelines and legislation and the status of renal replacement therapy in this country.


Authors' affiliations

M Davies, Division of Nephrology, Helen Joseph Hospital, and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Z Cassimjee, Division of Nephrology, Helen Joseph Hospital, and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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Keywords

End-stage kidney disease; Dialysis; Transplantation; Resource allocation policy

Cite this article

South African Medical Journal 2021;111(7):615-619. DOI:10.7196/SAMJ.2021.v111i7.15395

Article History

Date submitted: 2021-06-30
Date published: 2021-06-30

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