Thursday, February 26, 2015

[YOUR HEALTH] More Nigerians in their 30s have kidney failure

Image result for African man in dialysis hospital

Emmanuel! Emmanuel! Please come forward!” A nurse at the dialysis unit of the Lagos University Teaching Hospital, Idi-Araba, beckoned to a frail-looking boy who was taking a nap in one of the chairs at the clinic.

He walked sheepishly towards the nurse to an adjoining room in the clinic as if he was being led to a slaughter slab. Going by Emmanuel’s gait, it looked as if he had premonition of what might happen next to him

Then almost immediately, the nurse expertly began attaching tubes from the dialysis machine to the young man’s body. He shut his eyes for the next 30 minutes as he allowed the.....
treatment take its course.

Emmanuel, a 20-year-old undergraduate of the University of Lagos, Akoka, has kidney failure, a factor that explains why he frequently visits LUTH. In fact, the young man visits the teaching hospital every three days to undergo a dialysis – a procedure that manually takes waste substances out of his body.

“I noticed two years ago that I was not urinating regularly. I usually wake up with swollen feet and face but I thought it was just stress. I could also not sit through lectures without feeling sick or breathless.

“I was treating malaria twice a month because I was always feeling weak and feverish. It was when I collapsed in class during a lecture and my classmates brought me to LUTH that it was found out that my kidneys has failed,” Emmanuel notes as he narrates his tribulation to our correspondent.
The young man, who claims he has dropped out of school, says there is no way he could have coped with challenges accompanying the illness. The fact that he spends more of his days in the hospital than in school, he adds, prompted the decision.

Beyond the financial demands, Emmanuel says, the diagnosis of a kidney disease can be devastating physically and emotionally.

Mrs. Shade Shokefunmi shares the same belief with Emmanuel. Shade’s long and ugly narrative began in 2013 when her accountant-husband, Olalekan, who works in a government parastatal, collapsed in his office.

Prior to this unfortunate incident, Olalekan was a comfortable man by all standards, especially as he owned a befitting property in one of the choice areas in Lagos.

However, the kidney failure problem Olalekan has altered his storyline. According to him, while gathering more money to pay for a kidney transplant surgery in India, he had to pawn off all he worked for in the last 20 years to raise funds for his weekly dialysis in LUTH.

He laments, “I have spent everything I have. I have sold everything I considered as assets to remain alive. In fact, a huge debt now hangs on my neck like an albatross.”

More threats on the horizon

Olalekan and Emmanuel are not the only young and promising Nigerians that have felt the pang of frustration and misery associated with the disease. The story of Olaide Nasir is even more moving and poignant.
In fact, plans for Nasir’s wedding ceremony were almost at the zenith last November when a diagnosis report revealed that he was down with a renal failure.

Since then, friends and family members of the 31-year-old police officer have diverted the funds they had planned to spend on his marriage ceremony to paying for his hospital bills. As our correspondent finds out, the wedding has yet to hold just as his family members and associates have yet to come out of the accompanying turmoil occasioned by the sickness.

Before now, Nasir was an active law enforcement officer. But today, he is not only a pale-looking young man, he is also barely hanging unto his life at the Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, which has become his new abode.

Nasir, whose voice is barely audible nowadays, says he collapsed while monitoring an election in Osogbo. With a deep frown on his face, the policeman, whose monthly earning is N43, 000, says meeting his financial responsibility concerning his health is an uphill task.

He notes, “How do I get the N60, 000 costs for the weekly dialysis. Beyond that, how can I gather N7m I need for a kidney transplant?”

Popular music producer and singer, OJB Jezreel, actor Olukayode Odumosu, popularly known as Pa Kasumu, and Ngozi Nwosu also became charity cases when diagnosis reports showed that they were down with kidney failure some few years back.

If not for speedy intervention from some state governments and kind-hearted Nigerians, they might not have survived the disease. Indeed, Nigeria recently lost a bright actor, Muna Obiekwe to kidney disease.

Experts’ submissions

With these cases, it is therefore not surprising that kidney care specialists in the country have raised the alarm that the number of persons with kidney-related disease is increasing.

A consultant nephrologist (kidney specialist), Dr. Ebun Bamigboye, admits that the incidence of chronic kidney failure in the country is not only increasing but also is at an alarming rate.

According to him, at least, one in every seven Nigerian is suffering from one stage of kidney disease or the other.

Bamigboye notes, “We estimate that we get about 15,000 new patients with chronic kidney disease every year. About 50,000 patients in Nigeria require dialysis, but just 1,000 are on it as we speak. The prevalence rate of kidney failure in Nigeria is 15 per cent and this is high in every sense.”

The nephrologist, who is the head of the Kidney Care unit, St. Nicholas Hospital, Lagos, adds that the reason for this increase is that Nigeria has one of the highest populations of people living with hypertension and diabetes, HIV and other infections, which are major causes of kidney failure.

He declares, “Nigerians are predisposed to kidney diseases because one out of four of us have hypertension. In Lagos alone, diabetes incidence is 10 per cent. Infection is common; HIV prevalence is about four to five per cent; 15 per cent of Nigerians have Hepatitis B, six per cent have Hepatitis C. All of these cause kidney failure, so it is expected.”

Another Consultant nephrologist at the Lagos State University Teaching hospital, Ikeja, Dr. Olugbenga Awobusuyi, states that going by the sharp increase in the number of patients down with renal disease, Nigerians should prepare for more cases of kidney failure in the next 10 years.

Awobusuyi is specifically worried that instead of the elderly, it is young Nigerians in their 20s, 30s and 40s that are now down with the chronic disease.

He adds, “In developing countries, the average age of persons with kidney failure is 60 and above. In Nigeria, it is about 35, because we see people in their 20s, 30s and 40s with chronic kidney disease coming for dialysis. This is not good because these patients are at their prime. They are potential bread winners in their families and this is really not good for the country economically.”

He further attributes this peculiar situation in the country to the increasing population of young Nigerians contracting HIV/AIDS, and hepatitis.

“The incidence of chronic kidney diseases is increasing globally but the Nigerian situation is worse. We have a double tragedy on our hands.

“We are dealing with diabetes and hypertension and we also have many young people contracting infections, such as HIV, which affects the kidneys too.  We also have many Nigerians who have hepatitis.

“There are severe forms of malaria that when they are not well treated can injure or damage the kidneys. Any severe infection will affect blood flow to the kidneys and possibly damage it overtime and we know that infection is rampant in Nigeria,”Awobusuyi notes.

Resort to Agbo, abuse of analgesics

One only needs to visit some motor parks and garages in various parts of the country to know the herbal drug business is booming more than ever.

Many Nigerians start their day drinking herbal cleansers, which, they argue, would ‘cleanse’ their system of all waste and toxic substances.

Though the efficacy and safety of these local concoctions remains a subject of debate in the medical world, hundreds of Nigerians keep taking recourse to these herbal cleansers. Meanwhile, orthodox medics hold the view that these cleansers pose a great danger to the health of the consumers.

In fact, doctors have linked the consumption of these substances to increasing population of Nigerians being down with kidney problems.

Awobusuyi says, “Traditional medicine practitioners will always tell people that herbs are safe because they are just leaves, so they can’t damage the body but that is not true. Some of these herbs and herbal preparations are injurious to the kidneys, and cause kidney damages

“All these foreign herbal drinks that are the fad these days will land many Nigerians in trouble. They contain unacceptable levels of potassium that corrode the kidneys and affect its functions.”

He also warns Nigerians to stop buying drugs from unqualified persons when they are sick. According to him, many of them use such opportunities to sell expired and fake drugs which could damage the kidneys.

“There is this mixture, they call Akanpo. They combine all classes of orthodox drugs and sell to people. This is dangerous because some orthodox medicines like gentamycin were banned because they damage the kidneys. These quacks don’t know that; they will buy them and give to people to drink. They may give people expired and fake drugs that contain harsh chemicals that can damage the kidneys just to make profit.”

For Bamgboye, this “self-medication fashion” is another major habit killing many Nigerians. Besides, he frowns on abuse of analgesics, especially the ones sold over the counter.

“Abuse of simple analgesic like pain killers that we use for headaches will over time damage the kidneys. They actually have their prescribed dosage and we should follow it.

“It is also not in our place to be treating malaria anyhow. Drugs are not sweets. They are chemical substances that should be taken under supervision and with care.”

Also, kidney specialist with the National Hospital Abuja, Dr. Agnes Eguagie, says prolonged consumption of analgesics also causes damage to the kidney and the liver. Eguagie states that analgesics include Non-Steroidal Anti-Inflammatory Drugs such as Ibuprofen and Feldene.

She says, “For people who tend to take these drugs for one month or two months continuously they will have a problem because it has been found to be a cause of kidney failure, when you have prolonged usage of analgesics.

“The liver and the kidneys are involved in clearing most of these drugs. So sometimes you might have liver toxicity from such drugs, if they are taken for long periods. ”

The doctors also  warn against uncontrolled alcohol consumption, smoking, abuse of bleaching creams, all of which, they say, could overwork kidneys and lead to their failure over the years .

Awobusuyi adds, “ Too much alcohol  or smoking can increase the blood pressure levels, and this over time can lead to kidney disease. But whether you drink or not, if you have high blood pressure and you don’t manage it by taking your drugs regularly, your kidneys will fail one day.”

FG should pay for dialysis

Renal transplant survivor, Stella Emmanuel, is concerned about the fate of other renal patients in the country, due to the lack of renal transplantation facilities in spite of the number of Nigerians who need this intervention on a daily basis.

Emmanuel, who sold her house for her to cater to her surgery in India, notes that the high cost of dialysis and kidney transplantation surgery is a major reason why many Nigerians are dying of the disease.

According to her, lack of dialysis facilities in many locations in the country, especially in the North and the Eastern parts, in addition to the actual treatment, are killing patients.

She recalls, “When I was undergoing dialysis, patients came from Warri and other cities to Lagos, to have dialysis. Bear in mind that these people are not even in the best state of health. Dialysis is also not cheap. Each session is N35, 000, and you are to have thrice in a week.

“How many people have N400, 000 to spend on medical treatment each month? Many do not even earn up to that. I had to sell my house to be able to afford my transplant and dialysis.”

Emmanuel also appeals to the Federal Government to facilitate drugs for survivors so that they won’t have to travel out of the country each time they need medical attention.

She says, “I can tell you that having a renal transplant is no joke; you must keep taking drugs and do checkups to make sure that the body accepts the new kidney. It is a strange object and that is a whole lot of trauma. Worse still, if you cannot afford necessary drugs, the kidneys will fail again.

“Just the same way the government provides free drugs for people living with HIV/AIDS, I think it would be great if it makes a similar provision for renal transplantation survivors too. You must have spent so much already on transplant and to ensure that those who have had transplantation actually survive, there must be an official intervention.”

Similarly, Awobusuyi calls on the Federal Government to include the cost of dialysis as part of the treatment that Nigerians can access under the National Health Insurance Scheme.

-Punch

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