Background. The magnitude of the problem of chronic kidney disease (CKD) is enormous, and the prevalence keeps rising. To highlight the burden of CKD in developing countries, the authors looked at end-stage renal disease (ESRD) patients seen at the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria. Method. ESRD patients seen from 01/05/1990 to 31/12/2003 were recruited. Records from A&E Department, medical-out-patients, wards and dialysis unit were used. Results. A total of 1001 male versus 537 female patients were reviewed. About 593 male versus 315 female patients had haemodialysis. The mean age was years and 86.5% were <60 years. Primary renal disease could not be determined in 51.6% while hypertension and glomerulonephritis accounted for ？17.2% and 14.6%, respectively. Death from renal causes constituted 22.03% of medical deaths. Conclusion. The prognosis for CKD patients in Nigeria is abysmal. Only few patients had renal-replacement-therapy (RRT). The prohibitive cost precludes many patients. This underscores the need for preventive measures to reduce the impact of CKD in the society. 1. Introduction The magnitude of the problem of chronic kidney disease (CKD) is enormous, and the prevalence of kidney failure is rising. Currently, CKD is emerging as a worldwide public health problem. The World Health Report 2002 and Global Burden of Disease project reports show that diseases of the kidney and urinary tract contribute to the global burden of diseases—with approximately 850,000 deaths every year and 15,010,167 disability-adjusted life years. Globally, they represent the 12th cause of death and 17th cause of disability [1]. This may however be an underrepresentation of the contribution of CKD to global burden of disease. Apart from the effect on kidney function per se, kidney damage is a major determinant for the development of progression of accelerated atherosclerosis, ischaemic vascular disease, and cardiovascular death [2]. Individuals with even the earliest signs of CKD are at increased risk of cardiovascular disease and may die long before they reach end-stage renal disease. The burden of CKD is therefore not limited to its impact on demand of renal replacement therapy (RRT); it is paralleled by the huge cost of provision of health care services for these patients. The cost of care includes not only the direct cost of dialysis and transplant services but also indirect cost like man hours lost at the workplace. In Nigeria, the situation is such that CKD represents about 8–10% of hospital admission [3, 4]. This may be a
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