Chronic kidney disease (CKD) is now a global epidemic which comes with adverse economic and medical consequences more so to the developing countries as a result of the substantial proportion of patients with end stage renal disease (ESRD) who need renal replacement services. This piece of research strives to unravel the myriad of challenges facing people with CKD in their quest for timely renal services in a resource constraint setting.It was conducted in the only National referral hospital in Kenya,the largest in East and Central Africa and truly epitomizes the scramble for limited centralized health services in a society where the per capita income between the urban working class and the rural folk is ever gaping. This makes quality,affordable health-care a privilege rather than a right to the less well-to-do citizens and especially those battling with the burden of chronic kidney disease who require dialysis services in order to stay alive.This book gives the reader a glimpse of an African perspective of the struggles that people with CKD have to contend with on day to day basis in pursuit of renal services.

Dr. Duncan Killingo is a Consultant Physician with the Ministry of Medical Services, Kenya.He holds an MB.Ch.B & M.Med. degree in Internal Medicine from the University of Nairobi, Kenya. His interest is mainly in the prevention of cardiovascular disease burden in Kenya.He is curently the Physician in Narok county,the home to the Maasai Mara!.