Adeze Ojukwu 

Chronic Kidney Disease (CKD), a debilitating non-communicable condition, affecting nearly 850 million people worldwide, has become a major global concern. Experts fear the silent killer has reached exponential  proportions, with the epicenter in Africa and Asia, due to apparent vulnerabilities. These daunting issues resonated, again this week, as the global community marks another World Kidney Day(WKD), with renewed focus on accelerating affordable services to people.

This year’s theme tagged: ‘Kidney Health for Everyone Everywhere – from Prevention to Detection and Equitable Access to Care,’ centers on strategies to combat prevalence and impact on patients. The treatise, established in 2006, is a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF).

The annual campaign observed in March, focuses  on the importance of the kidneys and  the need to mitigate  frequency and toll of the disease on sufferers by institutionalizing quick response mechanisms.

The Foundation said ‘the global burden is escalating, with ‘one in 10 adults, representing about 850 million people has  CKD. It is projected to become the fifth most common cause of years of life lost globally by 2040 and a major cause of catastrophic health expenditure. Costs of dialysis and transplantation consume 2–3 percent of the annual healthcare budget in high-income countries,’ while most  patients in low-income countries have insufficient access to these life-saving treatments.

Stem cell therapies, hopefully, hold high prospects, with Regeneration Center Thailand, saying ‘Kidney stem cell therapy offers an alternative to transplantation.’

‘With millions of people using renal replacement therapy and dialysis, CKD and End-Stage Renal Disease ‘ERSD’ are increasingly common in global stem cell trials. Cellular therapies are currently used in treating Polycystic Kidney Disease(PKD).’ However, the Food and Drug Administration(FDA) has not approved stem cell kidney treatments in America. Dr  Theophilus Umeizudike, Consultant Nephrologist, Lagos State University Teaching Hospital  (LASUTH), said ‘more standardized research is necessary before it can be approved for human use.’ Cheerily, CKD ‘can be prevented, while progression to the end-stage can be delayed, with early diagnosis and medication.’ However, many countries lack effective policies on CKD, ‘a progressive loss in kidney function.’

Early detection is crucial in reducing  mortality rates, hence the need for people to go for regular health checks and avoid risky behaviour, including smoking, taking excessive salt and high protein diet. ‘Two new studies from the Netherlands and Korea suggest that high-protein diet is harmful, even to normal kidneys, and worse for obese or diabetic patients and  those with prior cardiovascular events, or a solitary kidney.’ The disorder includes kidney damage, kidney stones, diabetic nephropathy and PKD.
United States(US) Center for Disease Control  (CDC) identified major risk factors as ‘diabetes mellitus and hypertension. Others include sedentary lifestyle, obesity, advancing age, and genetics.’ Dr Umeizudike said ‘major causes in Nigeria include chronic glomerulonephritis, HIV infection, sickle cell disease, systemic lupus erythematosus, PKD.’ Sadly the impact of kidney failure, on patients and their families is gruesome, even for survivors.

This is largely due to extraneous circumstances,  complications and prohibitive bills.

Indeed the kidney is,  a complex and vital part that requires special care and maintenance. Its multifarious functions in blood production, waste removal, fluid balancing and blood purification, accord it a critical position in human health. Its continuous blood flow, makes it vulnerable to damages from metabolic diseases and infections.

WKD  encourages public activities, such as walks, free health screenings and media publicity to increase awareness and government action on renal care. Its  ultimate objective is to mobilise communities and world leaders to accentuate initiatives to improve patient care and survival rates. This is quite pertinent for Nigeria, where renal management  is ineffective, a tragic reflection of the nation’s decadence,  culminating in its current status, as the world’s poverty capital.

The incessant demand for a holistic review of the health sector, in tandem with global benchmarks for budgetary allocations and medical services is quite imperative. The lackadaisical approach of  the nation’s administrators to international treaties is appalling, because government officials and their cronies  patronise foreign hospitals, allegedly with public funds, thus undermining citizens’ welfare and infrastructural development. Stakeholders attribute this absurdity to widespread corruption and administrative ineptitude, thus precipitating low-life expectancy, epidemics, food scarcity, socio-economic crisis and general malaise in society.

Clearly, the authorities should go beyond rhetorics and advance innovative schemes to curb the disease across the country, because of the centrality of kidney health to life and productivity.

The suffering of renal patients in Nigeria is quite heart-stirring, due to huge costs of dialysis, transplantation and hospitalization, culminating in hopelessness, depression and high mortality rates.

This administration should establish more renal clinics, in order to facilitate effective service delivery on demand. It should also go beyond the usual   phantom displays on WKD, to integrate approprite facilities, within the nation’s health framework, to contain the scourge.  With the nation’s  high unemployment and poverty levels, many patients can hardly pay for dialysis and replacement surgery. Government can emulate other countries, such as Tanzania, India and China, where renal facilities are free or highly subsidized, because they place high premium on citizens’ welfare. Some notable  institutions, which  offer subsidized treatments include Muljibhai Patel Urological Hospital(MPUH), India. The Managing Director, Col(Dr) Arun Rastogi said MPUH, a top nephrology-cum-urological super-specialty hospital,  ‘provides affordable services especially in kidney transplant and stone surgeries, to help needy patients.’ ‘For us every life matters and deserves quality health care service,’ Dr Rastogi added.

‘This edition places a great demand  on government to establish more renal centers,  especially in vulnerable communities,’ Umeizudike added. The Federation bemoaned ‘the plight of disadvantaged populations, saying ‘ethnic minorities, rural dwellers, women, children and the elderly should be emphasised.’ ‘Some communities in higher and lower income countries are at greater risk than others, because of ethnicity and socio-economic status, evident in disparities in survival rates, access to standard hospitals and cheap medications.

Clearly, Nigeria needs to mount a comprehensive  campaign to combat kidney disease and its humongous toll on citizens.

Ojukwu is a Lagos-based journalist and Hubert H Humphrey(HHH) Fellow

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