Saturday, October 09, 2010

Kidney disease under diagnosed & unrecognized in Nigeria

Following my lung transplant almost 9 years ago I've been diagnosed with chronic kidney disease (CKD) secondary to calcineurin inhibitor (cyclosporine) toxicity. Now I'm paying more attention to it's prevalence and the role kidneys play in our lives. This article from Nigeria gives an excellent overview of how our kidneys work and highlights the enormous problem that CKD is for millions of people worldwide. In the U.S. alone most of the people registered for an organ transplant are kidney patients. Here are the latest statistics as of Sept 24, 2010.
  1. Kidney 91,867
  2. Liver 16,696
  3. Pancreas 1,449
  4. Kidney-Pancreas 2,278
  5. Heart 3,159
  6. Lung 1,821
  7. Heart/Lung 78
  8. Intestine 255
  9. Total Registrations: 117,603
For renal failure patients, hope beckons
From BusinessDay, Nigeria
Statistics from medical experts have revealed that more people die every day from kidney-related diseases than malaria and HIV/AIDS in the country. The main function of the kidney is to remove waste products and excess water from the blood. It allows consumption of a variety of foods, drugs, vitamins, supplements, additives, and excess fluids without worry that toxic by-products will build up to harmful levels.

The kidney also plays a major role in regulating levels of various minerals such as calcium, sodium, and potassium in the blood. However, in Nigeria, it is well known that Chronic Kidney Disease (CKD) is under-recognised and diagnosed. It is of note that healthy kidneys clean the blood by filtering out extra water and wastes, make hormones that keep the bones strong and blood healthy. When both kidneys fail, the body holds fluid and blood pressure rises. Harmful wastes build up in the body, not enough red blood cells are produced leading to fatigue, nausea, and loss of appetite.

In fact, chronic kidney disease is a problem of enormous magnitude, and its prevalence is on the increase. Currently, CKD is 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 are responsible for approximately 850,000 deaths every year and 15 million disability-adjusted lives. Globally, they represent the 12th cause of death and 17th cause of disability.

Ebun Bamgboye of St. Nicholas Hospital Lagos, stated in his speech at an international symposium on chronic kidney disease and renal transplantation, organised by the hospital recently, that more than 5 percent of the adult population have some form of kidney damage, and that every year, millions of people die prematurely of cardiovascular diseases linked to CKD.

Therefore, the burden of CKD on the society needs proper attention to enable government and non-governmental organisations nip it in the bud. The availability of dialysis and kidney transplant facilities in the country is minimal, as access to it and transplant programmes in Africa is dependent on the availability of funding and donors with majority of those with CKD dying because of lack of fund as very few can afford regular dialysis or transplant.

To this effect, MTN Foundation (MTNF) has decided to do something about this ailment that is claiming the lives of many, especially the less-privileged in society. MTN Nigeria through its Foundation established in 2004, has set out to support the health system by providing haemodialysis medical equipment to, at least, 11 hospitals across the six geo-political zones of the country.

This initiative has received applause from the public because it has created avenues through which citizens of the country can access therapeutic dialysis against the scourge of renal failure. Sufferers within and around General Hospital, Alimosho, Lagos State; Federal Medical Centre, Owerri, Imo State; Benue State University Teaching Hospital, Benue State; Federal Medical Centre, Yola, Adamawa State; Braithwaite Memorial Specialist Hospital, Port Harcourt, Rivers State; General Hospital, Calabar, Cross River State; General Hospital, Yauri, Kebbi State; Specialist Hospital, Sokoto, will easily receive treatment.

Also recently, University Teaching Hospital Ekiti, Ado-Ekiti got its haemodialysis centre commissioned. The facility, which consists of two Fresenius haemodialysis machines, two electronically-powered dialysis chairs, water treatment unit and pre-treatment unit, borehole water facility, two back-up power (3KVA UPS), 2.2 KVA UPS for water treatment unit, 1.5KVA UPS for water pre-treatment unit, 27KVA power generator and four air conditioners was inaugurated so that sufferers within the state and its surroundings can get cheaper treatment than that offered in private hospitals.

Experts are of the view that early detection can help in the management of these afflictions and reduce mortality. When a person is diagnosed with CKD, the treatment can be through transplant of a healthy kidney from a compatible donor through surgery or use of drugs called ‘immunosuppressant’s’ to subdue the recipients’ immunity from fighting the ‘foreign body.’ This is not done in Nigeria at present and it is very expensive, costing about N2 million apart from travel expenses. The other alternative is to undergo dialysis through the haemodialysis equipment, at least, three times a week. Here, the person’s blood is drawn into a machine, filtered and returned back. It takes time, as the person has to sit for three to four hours.

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