In Nigeria, the leading cause of kidney disease are high blood pressure, diabetes and kidney inflammation. Other causes of kidney disease include high cholesterol, kidney infections, kidney stones, polycystic kidney disease, environmental pollution, unsafe drinking water and abuse of painkiller medications. Older people and individuals who smoke or are obese have a greater likelihood of developing chronic kidney disease.
The statistics by the Nigerian Association of Nephrology (NAN) showing that a staggering 13.9 percent of the 180 million Nigerians are suffering from kidney failure also reveals that majority of sufferers are of the working-age population, with the condition resulting in loss of jobs and poverty. Information from NAN showed that the condition not only gulps huge sums of money for treatment, it also leaves the sufferers constantly tired, in pain and at risk of death.
Why are 20 million Nigerians at risk?
Kidney disease refers to the injury or damage to the kidneys that has usually been on for a long time.
Chronic kidney disease or CKD is a progressive condition that reduces kidney function (basically its ability to filter waste from the blood). Chronic kidney disease often has no symptoms in its early stages and can easily go undetected in most people until it is in its advanced stages.
In this late or advanced stage of CKD, an individual can develop kidney failure and require dialysis or a kidney transplant to maintain life. At this stage, a CKD patient is said to lose 85-90 per cent of their kidney function; not enough to keep the person alive, without medical intervention.
In Nigeria, the leading causes of kidney disease are – high blood pressure, diabetes and glomerulonephritis (kidney inflammation from a variety of causes). In 2019’s World Kidney Day celebrations in Nigeria, an alarm about two new leading causes of kidney diseases for Nigerians was raised. These were identified as toxicity caused by long term drinking of traditional herbal concoctions and exposure to harmful chemicals due to long term use of skin whitening creams.
In Nigeria, other causes of kidney disease include high cholesterol, kidney infections, kidney stones, polycystic kidney disease. In addition, environmental pollution, unsafe drinking water, abuse of analgesics and use of pesticides have also been linked to the development of kidney disease. It is also worth noting that there are certain high-risk groups. Older people, individuals who smoke and are obese have a greater likelihood of developing CKD.
A Nephrologist’s viewpoint
Moses Tari, a Nephrologist at the Federal Medical Centre, Birnin Kebbi, said kidney disease makes up a large part of daily hospital admissions in Nigeria.
“It affects all ages and genders and commonly complicates diabetes, and hypertension. Most patients present late, requiring life saving interventions and procedures.” He noted further that “chronic kidney disease constitutes about 40 per cent of referrals to tertiary hospitals. It is an almost constant scenario after reviewing the daily admissions of most tertiary hospitals.” For Mr Tari, “most cases of CKD present when the kidney function cannot sustain normal life and the patients require emergency dialysis to stay alive”.
Dying for Dialysis
With the cost of dialysis sessions ranging from N20,000.00 to N50,000.00 per session. It is worth noting that the global standard recommendation for dialysis is a number of 3 sessions a week for an average of 3-5 hours. However, a study labelled the rate of adherence a “fry cry from the recommended standard” in Nigeria. On account of the cost, a person suffering from kidney failure reportedly opts for fewer dialysis sessions; sometimes even once a week. Another study in Nigeria noted that none of the 101 participants in the Ekiti University Teaching Hospital’s dialysis centre could maintain three sessions per week for three months. The discontinuation of dialysis is frequently reported in Nigeria and has serious health implications on those suffering from Kidney failure. Also, with few Nigerian tertiary health facilities having functional dialysis treatment centres, the prognosis for CKD patients in Nigeria seems all too bleak. Not surprisingly, most CKD patients in Nigeria travel long distances from state to state, searching for cheaper dialysis centres with functioning units. In some states, tertiary facilities often have no dialysis machines.
All of this is further exacerbated by the fact that the alternative to dialysis which is transplantation is not one many can turn too either. The cost of a kidney transplant is indeed over N6,500,000.00.
Call to action
Despite years of advocacy actions by the Nephrology Association of Nigeria and other pressure groups, the National Health Insurance Scheme (NHIS) in Nigeria currently only provides limited coverage for CKD patients.There is increased and coordinated advocacy from nephrologists, cardiologists, haematologists to the government at national and state level to expand coverage for CKD patients as part of new efforts to bring the National Health Insurance under one roof. Moreover, the government must do more to educate the public on kidney disease prevention. There is little information to educate the general public on how to protect their health and prevent disease. More must be done in this important area of health promotion.
Most young ladies striving for a beautiful complexion are not aware that bleaching creams can cost them their kidneys and most patients managing diabetes type 2 are unaware that kidney disease can be a complication. Health promotion is thus central to address this gap in knowledge