Adebayo Sokunbi is the Operations Director of Kidney Consultants International, a non-profit organisation devoted to preventive education and screening of Nigerians for kidney failure. He is also council member of the International Federation of Kidney Foundations. He is currently on the board of Kidney Clinics Nigeria Limited,operators of the Abeokuta Dialysis Center. GBENGA ADERANTI had an encounter with him. Excerpts:
What are the causes of kidney failure?
Kidney failure could result from various factors. Most prominent among them are hypertension and diabetes. These two conditions often occur and without any discomfort symptoms at the on set. Most people do not know they have them until they undergo tests. Other factors like sustained abuse of analgesics, and traditional herbs have been linked with kidney damage also.
Renal failure is often responsible for high levels of morbidity and mortality. High casualty rates and poor health are common with people suffering renal failure. The disease is also stressful to family members.
At what age does it manifest?
Kidney failure occurs in children and adults with no specific age restrictions. It is disheartening to note that a lot of young men and women who have end stage renal failure are young and often in their econonomic active years or promising young students, the group has the a potential to contribute to Nigeria GDP.
How do you manage renal failure?
Renal failure in early stages may be managed by the use of medication and adopting special diets to ensure that failing kidneys are sustained for as long as possible. At end stage, the kidneys are no longer able to maintain the good health of the patient and their functions must be replaced by different renal replacement therapies like dialysis and kidney transplants. Dialysis involves passing the patient’s blood through a machine and artificial kidney for cleaning before returning it to the patient’s body . It is usually recommended to be done three times a week but most Nigerian patients cannot sustain this due to the cost. For this reason dialysis patients are very ill and die very often.
On the other hand, a transplant involves harvesting a healthy kidney from a healthy donor to a patient whose kidneys have failed. Currently in Nigeria, this is very expensive, running into millions of Naira and since patients and family members must pay in full for it, most patients have to ask kind Nigerians to help or have no treatment. Besides, anti-rejection drugs are very expensive and often out of reach of most Nigerian patients. In Sudan , the cost of post-transplant medications are borne by the state.
In Benin Republic, the cost of dialysis of patients is subsidised. This makes it possible to retain patients who can contribute to their countries’ GDP. Nigeria can learn from this to develop a practical renal policy with the professional advice from Nigerian Association of Nephrology and other relevant stake holders.
At what point does renal failure become dangerous?
Chronic kidney disease is not curable but its progression to end stage or what you call “dangerous” level can be delayed by competent professional management. An acutely affected kidney, on the other hand, if diagnosed promptly and treated with a few sessions of dialysis may regain kidney function. If not diagnosed promptly and treated, it may progress to chronic kidney disease. In general, patients should seek expert care and advice when their good health is in doubt. A regular medical check up is good as a long-term preventive measure.
How can one prevent renal failure?
Preventing renal failure is possible with healthy living. Also known hypertensive and diabetes patients must take their medications for life. Losing weight will help in this regard a great deal.
Renal replacement therapies are dialysis or kidney transplants. Both are expensive and out of reach of 90% of Nigerians except those who are lucky to have public or social institutions contribute to their care. Currently, the Nigerian Health Insurance Scheme (nhis) currently does not cover renal care.
How true is it that it is heredetery?
Genetic inheritance increases the likelihood of risk but does not mean all members of a family will have renal disease.
Can babies have kidney failure?
Babies may have kidney disease due to some harmful or toxic substances that may be ingested. Unfortunately insufficient records do not make it possible to determine accurate levels of its occurrence.
What are the symptoms of kidney failure ?
In the early stages, there are no noticeable symptoms, but as the disease progresses, a person with kidney problem is likely to be feeling unwell and may be having an unusual urine production or frothy urine. Others include fluid retention in body,high blood pressure and low red blood cells.
What is the relationship between diabetes and renal failure?
Diabetes is a condition that could progress to kidney damage if sugar levels are not adequately controlled.
How much does a patient spend on dialysis weekly?
Dialysis costs an average of N75,000 a week, excluding medications and lab investigations.
Do you think government is doing enough to arrest renal failure?
Government’s intervention is important and could be in form of preventive screening, research on cause intensity; and sustainable levels of subsidy could be worked out in partnership with the Nephrology Association of Nigeria (NAN) and other relevant and interested stakeholders. An official declaration of kidney failure as an epidemic maybe a significant step in the right direction. A combination of government, individuals and civil society groups will need to help subsidise treatment for Nigerians. This will go a long way to reduce deaths and improve quality of health and reduce socio-economic burden on family members too.
Is it possible for a pregnant woman to develop renal failure?
A complication of pregnancy elevates blood pressure; it may result in kidney damage if sustained.
What other things can kidney failure damage in the body?
The black men are genetically predisposed to hypertension, which, if not controlled or diagnosed timely, may contribute to kidney damage.
What is the effect on a kidney donor?
Transplant donors are usually certified medically fit to do so and generally do well afterwards.
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