Issues of Renal Replacement Therapy in Elders Living Low-Income African Countries

We read with interest the article by Smyth A about dialysis indications and the modalities of RRT in elderly patients (1). We would herein underline the particular situation in resource limited areas like sub-Saharan Africa where dialysis access is still very poor and nephrologists have often to make a selection among the growing number of and end-stage renal disease (ESRD) patients who need dialysis (2). We recently reported a high prevalence of chronic kidney disease (CKD) (10.7%) in black African patients aged ≥ 60 years with more than half of them presenting ESRD and having no access to renal replacement therapy (RRT) (3).