Ignorance Kills Kidney Disorder Patients

March 9, 2017 was World Kidney Day, a day set aside for global awareness on the importance of kidney. The day was part of the campaign to urgently reduce the risk factors for chronic kidney disease, CKD, in the world. This year’s theme was “Kidney Disease & Obesity”.

World Kidney Day promotes education on obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviours an affordable option.
Sunday Vanguard looks at the looming epidemic of kidney disease, the pains of getting treatment and the way out of the disorder.

Statistics from the World Health Organisation (WHO) show that kidney and urinary tract diseases ranked 12th on the list of major causes of deaths in Sub- Saharan Africa including Nigeria in 2012, with one million deaths.

In Nigeria alone, nephrologists say at least 36.8 million Nigerians (23 per cent), of the nation’s over 170 million population, are suffering from various degrees of kidney disease. An estimated 17,000 new cases of kidney failure are diagnosed in the country with only 2,000 having access to life-saving dialysis.

Most worrisome is the fact that children also fall victim to the disease. A study conducted at the Lagos University Teaching Hospital (LUTH) over a four-year period (2008-2011) showed that kidney-related diseases accounted for 8.9 per cent of paediatric admissions, with a prevalence rate of 22.3 admissions per 1,000 child admissions per annum. Yearly incidents also doubled during the study period. With the foregoing statistics, although WHO says about one in 10 people have some degree of CKD in Nigeria, one in seven Nigerians is affected.

Kidney disease in medical circle means that the kidneys are damaged and cannot filter blood like they should. This damage can cause wastes to build up in the body. It can also cause other problems that can harm your health. For most people, kidney damage occurs slowly over many years, often due to diabetes or high blood pressure. When someone has a sudden change in kidney function–because of illness, or injury, or has taken certain medications–this is called acute kidney injury. This can occur in persons with normal kidneys or in someone who already has kidney problems.

Anyone can develop kidney disease, regardless of age or race.

The main risk factors for developing kidney disease are diabetes, high blood pressure, cardiovascular (heart and blood vessel) disease, and a family history of kidney failure. Out of these, experts say diabetes and high blood pressure are the most common causes of kidney disease. These conditions can slowly damage the kidneys.

Unfortunately, early kidney disease has no signs or symptoms. Experts say you may not feel any different until your kidney disease is very advanced. Blood and urine tests are the only way to know if you have kidney disease. A blood test checks your glomerular filtration rate (GFR), which tells how well your kidneys are filtering. A urine test checks for protein in your urine.


Today, kidney disease has continued to wreak havoc in communities across the country. Reports of Nigerians begging for alms to enable them have themselves treated in countries like India are common place in our national dailies, almost daily.

Evidence abounds that more Nigerians are dying of kidney disease. Many notable Nigerians have succumbed to kidney disease. Top on the list are Steve Kadiri, a veteran journalist, and Inspiration FM presenter Chaz B. Kidney disease is said to be one of the diseases that has dangerously dug a big hole in the pockets of many Nigerian families. Cases of families selling their properties to get their loved ones go through dialysis are everywhere. Dialysis is a treatment that filters and purifies the blood using a machine. It helps to keep the body in balance when the kidneys can’t do their job.

The plight of patients

Whither Nigeria in the fight against kidney disease? This is the million dollar question on the lips of many families. Many people are dying of kidney disease due to ignorance or cost of treatment. The challenge of managing kidney disease in Nigeria is basically finance, because there is no social support for kidney disease treatments from government; as we speak, the money comes from patients.

The National Health Act is yet to be implemented.

Despite the enormity of the pain and agony kidney disorder patients go through, the government is yet to prioritise it. A year ago, the worsening rise in cases of kidney disease was a top concern during one of the National Council on Health meetings, where it was disclosed that Yobe State accounted for 35 per cent of the cases nationwide. Since then, there has not been any action at both state and national levels to tackle the deadly disease.

Although kidney disease is preventable and treatable, it is one of the most expensive disorders to treat and manage and, with the N18,000 minimum wage, the total lifetime cost of handling kidney disease in Nigeria is colossal.

For instance, a kidney transplant goes for about N5 million to N8 million. Unfortunately, not many patients can afford it. Dialysis costs between N25,000 and N30,000 per session, while most patients spend over N100,000 a week. One thing is that many of these patients do not have any inkling when they will be able to raise the money for transplant or find a suitable donor.

According to the President, Nigeria Association of Nephrology, NAN, Dr. Ebun Bamgboye, in a presentation titled: ‘The looming epidemic of kidney failure in Nigeria: The magnitude of the problem’, the Federal Government should emulate the US government that spends about US$30 billion every year to look after patients with kidney failure. Bamgboye called for the prioritisation of treatment of kidney disorders by extending the period of dialysis under the National Health Insurance Scheme, NHIS, from six sessions (two weeks) to 36 sessions (three months).

“Parents should take their children to hospital immediately any abnormality is noticed, rather than buying local herbs or taking them to native doctors. It has been discovered that local herbs are a major cause of kidney disease in Nigeria,” he warned.

11 factors, including untreated microbial infections, especially urinary tract infections (UTI), diarrhoea, malaria, hepatitis, Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS), diabetes, hypertension, potassium bromate poisoning, teething powder, abuse of painkillers/ analgesics, particularly paracetamol, have been identified as responsible for the rising cases of kidney failure in the country.

In a report, a consultant nephrologist, Dr Olugbenga Awobusuyi, also blamed the rising prevalence of CKD in Nigeria on the conditions such as uncontrolled diabetes and hypertension, explaining that the kidneys are endowed with functional reserves, which could prevent a patient from having any symptoms years after the disease might have set in. “In fact, this could delay symptoms until after 60 -70 percent of the kidney functions might have been damaged”, he added.

Stages to seek medical care

“CKD is preventable and many of the causes are treatable. If patients are diagnosed early enough, diabetes and hypertension can be well managed to prevent renal failure. This could be done by slowing down the deterioration rate of the kidney, thereby ensuring adequate management of the underlying conditions. Patients must always ensure they meet their doctors at the right time, as well as take their medications as prescribed. If this is done, there are chances that the rate of death associated with kidney failure would be reduced.

“The kidney actually excretes water and other waste products from the body; regulates the internal environment, by making the system conducive for the internal organs, and once it starts failing to carry out these functions, then it’s a symptom of an ailment.

“For instance, when a patient cannot eliminate the water he/she takes in, through sweat and urine, when he finds it difficult to pass out excreta, then there will be an accumulation of waste products in the body, which is an indication of kidney failure”.

To another consultant nephrologist, Dr. Amisu Mumuni, it is better to avoid kidney disease at all costs. Mumuni, of Lagos State University Teaching Hospital, LASUTH, said although kidney transplant remains the utmost treatment for CKD, getting donors is a big challenge along with huge amount of money required to sustain dialysis.

“Prevention is better than cure. If you have hypertension or you have a family history of hypertension, you should always check your blood pressure closely and be religious with your drugs by making sure that your blood pressure is monitored and controlled. The same thing is applicable to people who are diabetic as they must also watch their diets, do exercise, take a walk, avoid sedentary lifestyle, avoid alcohol, avoid smoking and food that contains excessive fat because fat doesn’t really work for kidney, it worsens complications and you also have to cut down intake of saturated fats.”

Meanwhile, a study published in The Pan African Medical Journal in 2015, entitled: ‘Prevalence of risk factors for chronic kidney disease among adults in a university community in southern Nigeria’, explained that the prevalence of CKD remains a global public health challenge, particularly in developing countries, like Nigeria, where people with the disease present late and may already be in need of renal replacement therapy. The study maintained that early detection of modifiable risk factors of CKD is a plausible strategy to reduce its prevalence and burden.

According to the study, there is need for continuous education, regular screening for early detection and early intervention by risk factor modification to prevent and/or reduce the growing burden of CKD.

However, in line with this year’s theme, the good news is that obesity, as well as CKD, is largely preventable. Education and awareness of the risks of obesity and healthy lifestyle, including proper nutrition and exercise, can dramatically prevent obesity and kidney disease.

However, just as this year’s theme centres on kidney disease and obesity, health watchers are worried that with more Nigerians getting overweight, developing hypertension and diabetes, the looming epidemic of kidney failure in the country may continue unless urgent attention is paid to it.

The health watchers also warned of the dire consequences of the inability of most patients to afford the high cost of treatment.

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Source: Vanguard

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