THE BURDEN OF KIDNEY DISEASE

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There is need for preventive interventions to avert the onset of the disease

The increasing burden of kidney disease in Nigeria was brought to the fore recently when the country, along with others, marked the World Kidney Day with the fitting theme, “Kidney Health for Everyone Everywhere.” Medical experts used the opportunity to harp on the need to intensify awareness campaigns and urgent intervention, particularly on preventive measures that will help contain the scourge. According to the President of the Nigerian Association of Nephrology, Ifeoma Ulasi, some 25 million Nigerians suffer from kidney disease which could lead to renal failure and death.

Indeed, kidney disease is emerging as a major health problem. The World Health Organisation (WHO) projects that about two million people in Lagos State are suffering from Chronic Kidney Disease (CKD). “It affects all ages and genders and commonly complicates diabetes, and hypertension. Most patients present late, requiring life-saving interventions and procedures,” said a Nephrologist at the Federal Medical Centre, Birnin Kebbi, Moses Tari. Kidney disease, according to him, makes up a large part of daily hospital admissions and constitutes about 40 per cent of referrals to tertiary hospitals in Nigeria. A study conducted between 2008 and 2011 at the Lagos University Teaching Hospital (LUTH) said kidney-related diseases accounted for 9 per cent paediatric admissions.

A leading cause of death in Nigeria as elsewhere, the disease refers to a condition where the kidney is unable to perform its functions effectively. It becomes a chronic disease when the ability to filter waste from the blood is seriously hampered. It could go undetected in the early stages because of lack of obvious symptoms. But at a later stage, referred to as end-stage kidney disease (ESKD), or end-stage renal disease (ESRD), the signs become obvious as unfiltered waste build up in the body. These come in form of frequent or infrequent urination, swelling in feet and ankles, shortness of breath, nausea and vomiting.

The leading causes of the disease are varied, ranging from high blood pressure, diabetes, sickle cell and kidney infection. According to experts, other predisposing factors include obesity, untreated microbial infections, HIV, tuberculosis, hepatitis and malaria. Smoking, toxicity due to long-term use of herbal concoctions as well as long-term use of skin whitening creams, unsafe drinking water, abuse of analgesics had also been linked to the development of kidney disease.

During the 2020 event, medical experts were emphatic about the need for preventive interventions to avert the onset and progression of kidney disease. This is instructive as managing renal failure is expensive. Very few people are enrolled on the National Health Insurance Scheme (NHIS) and even so, the coverage is grossly inadequate. Most individual patients can hardly afford the cost of medical intervention by means of dialysis to filter waste and extra fluid in the blood. A typical dialysis session, for instance, costs about N30,000 and least two or three times a week are required to keep the patient alive. About 18,000 of the 25 million Nigerians suffering from renal failure reportedly need regular dialysis annually.

The cost of an alternative, a kidney transplant, is even more prohibitive as it runs into millions of naira. The very few who can afford that often travel abroad for the operation since few hospitals in the country have the capacity to conduct such delicate surgery. “The awareness aspect is critical because people must be made to come to terms with the fact that they are, first of all, responsible for their health and wellbeing,” said Lagos State First Lady and medical doctor Ibijoke Sanwo-Olu. Indeed, people need to embrace healthy lifestyle by exercising regularly, eating a balanced diet and maintaining normal body weight. It’s time to place emphasis on reducing the risk factors.