Nanto Med - Blog #HaemodialysisNanto Med - Blog #Haemodialysishttps://med.nanto.com/blogs/tag/haemodialysisThu, 08 Oct 2026 16:13:18 -0700http://zoho.com/sites/<![CDATA[Kenya's first national kidney guidelines: what to know]]>https://med.nanto.com/blogs/post/kenya-national-kidney-guidelines-2026

The short answer: in September 2026 the Ministry of Health and the Kenya Renal Association launched The National Guidelines for the Prevention and Management of Kidney Conditions, First Edition 2026. They shift kidney care towards prevention and early detection, define the role of each level of care and set dialysis standards, including three haemodialysis sessions a week as typical.

These are Kenya's first national guidelines dedicated to kidney disease. They were launched at the opening ceremony of KRACON 2026 in Mombasa, and they matter to everyone from a community health promoter to a nephrologist running a dialysis unit. This post summarises what the guidelines say, in plain language, with section references so that you can read the original. We are an equipment supplier, not a clinical body: patients should discuss anything here with their nephrologist before changing anything about their care.

What are the new national kidney guidelines?

The guidelines were developed by the Ministry of Health in collaboration with the Kenya Renal Association and a multidisciplinary technical working group. According to the preface, that group included national and county governments, professional associations, training institutions, private institutions, implementing partners and patient representatives. They cover prevention, screening, diagnosis, management, referral and follow-up of kidney disease, with chapters on children, diabetes, infections, pregnancy, dialysis, nutrition and mental health.

The foreword, signed by the Director General for Health, sets out why they were needed: about 5% of deaths in Kenya are due to chronic kidney disease (CKD), and a health system focused mainly on end-stage kidney disease is "not sustainable". Earlier in the year, at the national World Kidney Day event, the Ministry put the number of Kenyans living with CKD at about 3.1 million.

Who should be screened for kidney disease?

The guidelines are clear that universal population screening is not cost-effective. Instead they recommend targeted screening of high-risk people (section 5.4), including people with:

  • high blood pressure
  • diabetes
  • heart and blood vessel disease
  • a family history of kidney disease
  • a past episode of acute kidney injury
  • conditions such as lupus, HIV or obesity
  • high-risk jobs or exposure to substances that damage the kidneys

The screening tests named are a urine albumin-to-creatinine ratio (ACR) and an estimated glomerular filtration rate (eGFR) from a blood test. For people who remain at risk, the guidelines recommend repeat screening every 6 to 12 months. This matches the international KDIGO 2024 CKD guideline, which also uses eGFR and albuminuria together to stage CKD.

If you have high blood pressure or diabetes and have never had these two tests, that is a reasonable question to raise at your next clinic visit.

What does each level of the health system do?

One of the most practical parts of the guidelines is Table 3 (section 2.2), which assigns roles by level of care:

  • Level 1, community: health promotion, early danger signs (swelling, blood in urine, less urine) and referral.
  • Levels 2 and 3, dispensaries and health centres: formal risk assessment and screening, initial management of blood pressure and diabetes, referral to level 4.
  • Level 4, county referral hospitals: diagnosis and staging, laboratory and imaging services, starting kidney-protective treatment, specialist consultation where available.
  • Levels 5 and 6, national and teaching referral hospitals: dialysis, transplant services, sub-specialist care, training and research.

The guidelines also list indications for mandatory referral to a nephrologist (section 5.11), and they note that late referral is associated with poorer outcomes, including emergency starts to dialysis.

How many dialysis sessions a week do the guidelines recommend?

Section 10.5 covers maintenance haemodialysis. The key points:

  • Haemodialysis for chronic kidney disease is typically performed three times per week, with each session lasting about 4 to 5 hours, although schedules may be individualised.
  • Recommended adequacy targets are three sessions a week, 12 to 15 hours in total, and either a mid-week Kt/V of at least 1.2 per session or a urea reduction ratio (URR) of at least 65% per session.
  • Twice-weekly schedules are generally insufficient unless the patient has significant remaining kidney function.
  • Dialysis must be done in government-accredited centres, by a dialysis-trained nurse or technologist, following an individual prescription reviewed regularly by the nephrologist.

Patients and families should know that how many sessions are funded is set separately, through the Social Health Authority's tariffs (Legal Notice 56 of 2025, as amended). If you are unsure how many sessions you need, or how your sessions are covered, ask your nephrologist and your unit. Do not reduce or add sessions on your own.

What do the guidelines say about dialysis equipment and monitoring?

For units, three points stand out:

  • Dialyzers. The guidelines recommend synthetic polymer hollow-fibre dialyzers with membranes that minimise complement and leukocyte activation (section 10.5.3). The prescription should specify efficiency, flux and size (1.0 to 2.1 m²).
  • Delivered dose. The dialysis team should routinely monitor delivered dose using Kt/V or URR. A prescription only works if the machine delivers it: blood flow, dialysate flow and session time all depend on equipment that is maintained and calibrated.
  • Laboratory monitoring. Section 10.5.9 sets a schedule: complete blood count, sodium, potassium, urea, creatinine, calcium, phosphate, alkaline phosphatase and albumin monthly; HIV, hepatitis B and hepatitis C serology every 3 months; parathyroid hormone, vitamin D and iron studies every 6 months.

The second point is where we work. A machine whose dialysate flow has drifted out of tolerance can quietly deliver less dialysis than prescribed. Nanto Med specialises in parts for the Fresenius 4008, 5008 and 6008, and if you run 4008 machines, our 4008 preventive maintenance guide explains the manufacturer's flow and pressure checks. We stock the genuine Fresenius TSC and maintenance kit and complete gear pump in Nairobi. For planning spares across a unit, see our parts sourcing handbook.

Where can I read the full guidelines?

The guidelines are published by the Ministry of Health, and the Kenya Renal Association hosts the full guidelines document on its website. The document states that any part may be freely reviewed, quoted, reproduced or translated with acknowledgement of the source, but not sold or used for commercial purposes.

Frequently asked questions

Are these Kenya's first kidney guidelines?

Yes. They were launched in September 2026 as the First Edition, and the KRACON 2026 programme described the launch as the Kenya Renal Association's first ever guideline launch.

Who should be tested for chronic kidney disease in Kenya?

People at high risk, including those with high blood pressure, diabetes, heart disease, a family history of kidney disease, past acute kidney injury, HIV, lupus or obesity. The tests are a urine ACR and an eGFR.

How many haemodialysis sessions a week do the guidelines recommend?

Typically three sessions a week, 4 to 5 hours each, totalling 12 to 15 hours. Your nephrologist sets your individual prescription.

What is a good Kt/V or URR?

The guidelines' targets are a mid-week Kt/V of at least 1.2 per session, or a URR of at least 65% per session. Your dialysis team interprets your results.

Should I change my dialysis schedule after reading this?

No. Discuss any questions with your nephrologist and your dialysis unit. These guidelines guide health workers; your care plan is individual.

This article is produced by Nanto Med for educational purposes. We are equipment suppliers, not clinicians. Nothing here constitutes clinical guidance. Patients should follow the advice of their nephrologist and dialysis team.

References

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