What is the cost of one more breath? For Zambians living with kidney failure, the answer is counted in kwacha, in hours spent tethered to a machine, and in the quality of life that slips away between dialysis sessions.
Kidney failure, the final stage of Chronic Kidney Disease, is a growing health concern worldwide and increasingly among young people.
It develops gradually, reducing the body’s ability to filter waste until patients depend on ongoing treatment to survive.
Globally, chronic kidney disease affects more than 800 million people over 10% of the world’s population while in Africa, prevalence estimates range between about 4% and 15%.
In Zambia, the scale of the problem is matched by its cost. Dialysis, the most common treatment, must be done three times a week.
A single session costs between K5,000 and K10,000, placing long-term care far beyond the reach of most households.
Public hospitals provide some access, but resources are stretched. There are often too few machines and long waiting lists. Missing dialysis sessions can quickly become life-threatening for patients.
Behind the numbers are families making difficult financial choices. Some sell assets or rely on fundraising, while others go without treatment.
This highlights the harsh reality that survival often depends on one’s ability to pay.
According to Changu Nyambe,29-year-old, Lusaka resident diagnosed two years ago, the cost is counted in more than kwacha.
“When my legs started swelling, I didn’t know it was my kidneys,” she said.
“Now my week revolves around dialysis. Three times a week, four hours each time. If I miss it, I can’t breathe properly by the second day.”
“You start measuring your life in sessions,Some months I manage all 12, some months I do eight and I just pray I’m strong enough,”Nyambe said.
Nyambe is now appealing to government to intervene in the high cost of treatment.
“We understand that machines and medication are expensive, but people are dying because they can’t afford to stay alive,” she said.
“I have had to rely on fundraising and help from relatives to keep going.”
But what does kidney disease cost before it costs everything?
Dr. Chilangwabuyo Kasiya,a Health Expert, explained how the disease moves in stages, each with its own financial weight.
According to Dr. Kasiya, management is mainly dietary,Patients control blood pressure and monitor fluid intake.
“Those changes aren’t so costly because your glomerular filtration rate is still okay,” Dr. Kasiya said.
“It’s still adequate. You just need some care.”
What happens when the body’s own pressure valve fails?
“The costs for those blood pressure medications vary anywhere between K200 to K500 over a two-week to one-month period,” Dr. Kasiya explained.
“You need something external to produce urine for you,” Dr. Kasiya said.
That means dialysis, three times a week, for life. The cost is high, and it comes with strict lifestyle changes.
A kidney transplant offers a more permanent solution, but it is far more expensive. Patients must find a compatible donor and pay for lifelong medication. For most, this option remains out of reach.