Socioprofessional Impact on Patients with Chronic Kidney Disease at Aristide Le Dantec Hospital in Dakar: Out-of-Pocket Expenditures Burden and Catastrophic Household Finances

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Background: Chronic kidney disease (CKD) represents a major public health burden in sub-Saharan Africa, predominantly affecting young working-age adults. Despite free dialysis policies implemented in Senegal since 2012, the broader socioeconomic consequences of end-stage kidney disease (ESKD) on patients and their families remained poorly documented. Aim: This study aimed to estimate the socioprofessional and economic impact of dialysis on ESKD patients and their families in 2019. Setting: The nephrology and dialysis department of Aristide Le Dantec Hospital, a national level III referral center in Dakar, Senegal. Methods: An analytical cross-sectional study was conducted from January to December 2019. Data were collected through medical record reviews and face-to-face interviews. Direct and indirect costs were calculated, and catastrophic health expenditure was assessed using a 20% annual household income threshold. Results: A total of 89 patients were enrolled. The mean age was 47.83 years and 87.36% had no health insurance. Weekly working hours declined from 38.32 before diagnosis to 4.93 hours after. Job loss affected 59.09% of patients. Nearly all patients (89.53%) reported social repercussions, primarily activity limitations. Additionally, 43.68% sold personal assets to cover treatment costs, and 18.39% contracted loans. Catastrophic health expenditure affected 95.98% of patients, with out-of-pocket costs representing 52.86% of total management expenditures. Conclusion: Despite state subsidies, ESKD imposed a devastating socioeconomic burden on patients and families. Strengthening health insurance coverage and expanding social protection for CKD patients is strongly recommended. Contribution: This study provides critical evidence on the socioprofessional consequences of ESKD in West Africa, informing equitable health policy and resource allocation for kidney disease management in low- and middle-income countries.