Simple steps like regular exercise and routine
medical check-up can prevent kidney disease,
OYEYEMI GBENGA-MUSTAPHA reports. To
mark The World Kidney Day on Wednesday,
some experts gathered in Lagos under the
auspices of an hospital to sensitise the public
on the disease.
Do you know your weight? Weight is not
decided by climbing on the weighing scale
but through a simple step of conversion:
Convert your weight from pounds to
kilogrammes. Your weight (in pounds) ÷
2.2 = your weight (in kilogrammes).
Convert your height from inches to meters.
Your height (in inches) ÷ 39.37 = your
height (in meters). Then calculate your
Body Mass Index. The result will determine
if you are overweight or even obese. If the
result indicates overweight or obesity, you
need to quickly do Proteinuria test to
determine if there is protein-in your urine,
so as to avoid kidney disease.
Simple way of calculating BMI in metric is
weight in kilogrammes divided by height in
meters squared. Since height is commonly
measured in centimeters, an alternate
calculation formula, dividing the weight in
kilogrammes by the height in centimeters
squared, and then multiplying the result by
10,000, can be used.
The Consultant Nephrologist at Obafemi
Awolowo University Teaching Hospital
Complex (OAUTHC), Ile-Ife, Prof Fatiu
Arogundade, gave this insight at this year’s
World Kidney Day with the phrase ‘Run
with the kidneys’, held by Cedar Group
Hospital inFESTAC, Lagos. The theme was:
Kidney disease and obesity .
According to Prof Arogundade, everybody
should do everything possible not to get
their kidney damaged and it starts with
avoiding its causes, and being vigilant on
ones urine. “An end stage kidney failure
does not occur suddenly, but gradually. If
one is conversant with his numbers- Blood
pressure, urine analysis, among others and
keep his weight down, one can easily
prevent kidney disease’’.
For instance foamy urine should not be
taken lightly, “A full bladder can make your
urine stream faster and more forceful,
which can cause foam. The urine can also
get foamy if it’s more concentrated, which
can occur due to dehydration or pregnancy.
Sometimes, the problem is your toilet but
protein in the urine is another cause, and
it’s usually due to kidney disease.
Unhealthy kidneys lose the ability to
remove protein waste and it starts to build
up in the blood. The condition is often a
sign of kidney disease. Healthy kidneys do
not allow a significant amount of protein
to pass through their filters. But filters
damaged by kidney disease may let
proteins such as albumin leak from the
blood into the urine. So one needs to do
Proteinuria test to be on the safe side. It
costs less than a thousand naira,” said
Prof Arogundade.
He said kidney disease often has no early
symptoms. One of its first signs is
proteinuria that is discovered by a urine
test done during a routine physical
examination. Blood tests will then be done
to see how well the kidneys are working.
On how obesity causes kidney disease, Prof
Arogundade said BMI under 18.5 – is
considered very underweight and possibly
malnourished, 18.5-24.9 – you have a
healthy weight range for young and
middle-aged adults, 25.0 to 29.9 – you are
overweight and over 30, you are considered
obese.
Prof Arogundade explained that, “Optimal
Body weight means the body mass index
(index is used to determine if somebody is
higher than normal or not). If it is higher
than 25kg per metre square that is
overweight. Optimal weight is between 20
and 25. If it is higher than 25, and still
hovers between 25 to 29.9, we define that
patient as being overweight. These set of
people are also exposed to the risks of
obesity. Those people with BMI above 30
as being obese.”
And the connection between obesity and
kidney disease? He said, “In terms of renal
failure, people that are overweight have
metabolic syndrome like abdominal
obesity, impaired glucose tolerance,
impaired fasting glucose or diabetes, hyper
lipidemia coupled with hypertension.
Presence of three or more of these
conditions in an individual prone the
person to kidney disease, the risk is higher
in them than a normal individual. So
people that are overweight should watch it
and bring down their weight to optimal
body weight of achieving a BMI of less
than 25kg per metre square.”
To a question on if there is rising cases of
kidney disease in the country, Prof
Arogundade said the seeming increase in
kidney cases incidence in Nigeria is due to
increase in awareness and increase in
kidney disease cases. “The percentage over
the years is still the eight percent we talk
of globally. Those that presented to the
hospital in community studies across the
country are high, ranging from 18 percent
of the population to 20 and 26. This is an
indication that that kidney disease may be
increasing in prevalence in our
communities,” he stated.
He advised that to beat down on being
overweight or obesity, one should exercise,
diet, and avoid excess salt and alcoholic
drink.
State of transplant
Prof Arogundade said there are options of
dialysis for anybody with kidney disease
that cannot be reversed. And should there
be need for kidney transplantation, Prof
Arogundade said one needs not travel
overseas because same is available in the
country. St Nicholas Hospital has done
about 70 percent of the total number of
kidney transplants in Nigeria. A new
entrant, Zenith Medical and Kidney Centre,
Abuja has done over 50 cases in about two
years. Government hospitals doing
transplants are not doing well because of
financial muscle of the patients, i.e.
affordability challenge. Many of the time,
the patients aren’t able to sustain the
treatment. Those that patronise the private
hospitals are rich, while some are
supported by NHIS. Aminu Kano Teaching
Hospital still transplants fairly regularly,
UCH less than a month ago did, like wise
OAUTHC but the frequency is a little lower
in these hospitals, but with improved
government support there will be more
transplants.
On life after kidney transplant, Prof
Arogundade told The Nation that Transplant
Association of Nigeria and the Nigeria
Association of Nephrology (NAN) are
working round the clock to bring down the
cost of post immune suppressive drugs.
“Recently, the Minister of Health, Prof
Isaac Adewole who chaired our conference
held at OAUTHC re-echoed government’s
feeling of concern of Nigerians dying of
kidney failure, so he said by next year, post
immune suppressive drugs for kidney
patients transplanted in Nigeria will be
free. Once this is available, the number of
people using expired or near expiry immune
suppressive drugs post transplant will be
addressed. In countries that are not as rich
as Nigeria like Sudan, Egypt post
suppressive transplant drugs are absolutely
free,” he stated.
Co-founder/Director Cedar Group Hospital,
Mrs Elizabeth Adamma Akpabio said the
hospital can assist people with kidney
disease get back their life because, “We’ve
been in existence since 2001, as part of
our corporate social responsibility, we’ve
been holding this lecture annually for three
years to create awareness about kidney
diseases in the community. The incidence
of Kidney disease is so high and rampant
that we resolved to embark on
enlightenment campaign on causes,
preventive measures and how to handle by
way of knowing where to go for further
assessment once the symptoms are there.
Our simple intervention through this way
has saved a lot of people by reversing their
kidney disease status, and others
undergoing dialysis or transplant. Some of
these people have also gone ahead to
spread the information in their abode and
places of work as a result of getting the
right information through us.”
She added: “We are happy to be in Nigeria
operating fully. We are playing a big role
by what we are doing thereby reducing
medical tourism. India and Dubai come to
mind once people want to have surgical
intervention but it is mostly Nigerians that
are there as the medics. So we are proud
that we have good hands here in our
hospital, and in the country such as the
renowned nephrologists, Prof Fatiu
Arogundade. He is usually invited overseas
to give lectures and perform transplants.
So if we have him here in our midst, why
then do we need to go out there? Here is
cheaper. There is no need for flight for the
patient and accompanied relations, or
instability with a new environment, also
family are around to give their support, so
also free accommodation.”
Consultant family Physician/Chief
Operations Officer, Dr Chukwuma Ogunbor
said Cedar Group Hospital was established
in 2010, but the dialysis centre came in
2011. “We are giving back to the
community in form of creation of
awareness on kidney disease which is a
chronic illness. Our charges are
surprisingly low compared with others. We
do not want people to come down with any
end stage, so checking blood pressure and
avoiding obesity are some of the ways to
avoid developing kidney disease,” he
explained.