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Published On: Tue, Mar 18th, 2014

Curbing kidney disease via early screening

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Chronic Kidney Disease (CKD) is gradually becoming a dominant public health problem in Nigeria.

It had claimed the lives of prominent citizens worldwide, including Nigeria’s former President, Alhaji Umaru Musa Yar’adua, who battled with kidney problems until his death.

Research findings show that “ CKD represents about eight to 10 per cent of hospital admissions in Nigeria.’’

Dr. Ifeoma Ulasi and Dr. Chinwuba Ijoma of Renal Unit, University of Nigeria Teaching Hospital, Enugu, in their 2010 research article, stated that the figure may be higher.

In the study titled: “Enormity of Chronic Kidney Disease in Nigeria: The Situation in a Teaching Hospital in South-East Nigeria,’’ the researchers noted that CKD were under diagnosed.

Dr. Aaron Obazele, a physician, said that many people were ignorant about the functions and importance of the kidney.

“One of the major functions of the kidney is to remove waste products and excess fluid from the body through the urine. They also remove drugs from the body.

According to him, when the kidneys stop performing these filtering functions properly, a renal failure is said to have occurred; and a kidney failure is when both kidneys are damaged.

Chief Medical Director, St. Nicholas Hospital, Lagos, Dr. Ebun Bamgboye, said that millions of Nigerians are suffering from various stages of kidney disease.

“Studies are ongoing that in Nigeria, probably about one out of every five of us has one stage of CKD or the other.’’

The Chief Medical Director said that diabetes and hypertension were the two most common causes of kidney disease.

He however said that “many people are dying from kidney failure because they are not able to access good health care.’’

Prof. Manoj Gumber, of the Institute of Kidney Diseases and Research Centre Ahmedabad, Gujarat, India, said most people may not have any severe symptoms until their kidney disease is advanced.

He listed the symptoms to include: “Fatigue, trouble with concentration, poor appetite, muscle cramp at night or swollen feet and ankles, puffiness around the eyes, itchy skin, constant urination, especially at night,’’ among others.

Gumber said that many kidney diseases could be treated successfully, especially with careful control of diseases like diabetes and high blood pressure.

He said that severe cases of kidney failure may be treated with “hemo-dialysis, peritoneal dialysis or Renal Replacement Therapy (RRT) or kidney transplantation.’’

According to him, the cost of live donor transplant is about N10 million.

A consultant nephrologist at the Federal Medical Centre, Owo, Dr. Lekan Ojo, said that kidney disease was on the increase in the country.

“CKD is much more common than people realise. Although there are no available accurate statistics, studies have shown that kidney disease affects about 20 to 25 per cent of the population,’’ he said.

Ojo described dialysis as the artificial process of getting rid of metabolic waste products and unwanted water from the blood when the kidneys were not functioning.

“Dialysis is necessary because approximately 200 litres of blood are filtered by a healthy person’s kidneys daily, and one cannot live if waste products are not removed from our kidneys’’.

Ojo said that for people whose kidneys were not functioning well, there would be a build-up of waste in the blood, such that without dialysis, the amount of waste products in the blood would increase.

“The grave consequence of this may be coma and possible death,’’ he said.

Ojo put the cost of RRT in Nigeria at about N25,000 per session, with the exclusion of drugs and other accompanying treatment.

“So, a range of between N5.2 million and N10 million would be an average cost of managing a patient in the end stage of chronic kidney disease, that required dialysis.

“It is expensive and that is why the government has to step in. We need more facilities that will offer dialysis and transplant services,’’ he said.

Early screening and detection, experts say, are critical in the management and treatment of kidney diseases. They also stressed the need for good health care facilities and increased awareness.

Dr. Bose Peters, an RRT survivor and the founder of Kidney Foundation for Africa (KFA), agreed that early screening would reduce the rate of kidney disease in the country.

“Early check and diagnosis to detect ailments can save Nigerians a lot of money for cost of travelling abroad for treatment.

“ Unfortunately, the scenario is that all of us with kidney damage go to India to have our kidney transplants done and you can imagine how much that cost.

“Our facilities are not equipped for transplants. The few that are here are very expensive and not accessible to people that don’t have money.

“In terms of screening, if we check our blood pressure, blood sugar and urine, kidney disease can be detected early and disease kept from progressing to kidney failure,’’ she said.

Dr. Olatise Olalekan, a consultant physician and nephrologist also called for more investments in the health sector.

“We can manage these diseases in Nigeria. The challenge is that government needs to invest more in the health care sector.

“Government needs to pay more attention on the need to include dialysis which is one of the treatment modalities on the health insurance scheme, as it is done in other parts of the world.

“Dialysis is self-funded in Nigeria, and as a result patients do not get the proper dialysis cycle and treatment that is needed,’’ he said.

Olalekan said kidney transplant programmes should be encouraged, as this would not only help patients who were not financially capable, but would also reduce medical tourism for kidney transplantation.

He appealed to the Federal Government to give import waiver for dialysis consumable goods in order to bring down the cost of dialysis. (Source: NAN)


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