Day 5 - Milligrams and Micromoles

My one regret is not having brought my PDA along to convert all the lab results from micro and milli moles to mg/dl. Imagine my surprise when I calculated the urea in a patient at 432 mg/dl and creatinine 24 mg/dl – needless to say, the patient was encephalopathic from obstructive nephropathy with severe bilateral hydronephrosis. We talked to the family about emergent dialysis but they could not afford it. The poor man passed away that same night.

I guess this is one reason why not many physicians are interested in Nephrology here. Dialysis treatments are exorbitantly priced for an average Ugandan family and transplantation requires travel to either India or South Africa. I have been told there are only 25 patients on hemodialysis at Mulago and only 4 dialysis centers in the whole country. I suppose, our patients are really fortunate in the US in that they are treated regardless if they can afford it.