25m Nigerians have kidney failure, says Nephrologists

• 18, 000 Need Dialysis Yearly
• Only 160 Nephrologists, Less Than One Per 1m Population
• About N400, 000 Needed For Dialysis Monthly

This year’s World Kidney Day will present a moment for sober reflection for the country following the revelation that a staggering 25 million Nigerians (13.9 per cent of the 180 million people) have kidney failure- a condition where the kidney can no longer work without dialysis or transplant.

This statistics by the Nigerian Association of Nephrology (NAN), 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.

“This fraction of people with Kidney failure, also known as End Stage Renal Disease (ESRD) is little, compared to the number of people living with kidney diseases in Nigeria,” the immediate past president of NAN, Dr. Ebun Bamgboye, told The Guardian.

According to Dr. Bamgboye, kidney diseases can be either chronic (a progressive loss of kidney function caused by long standing disease) or acute (abrupt loss of kidney function within seven days due to reasons such as heart attack, illegal drug use, infections).

“When a kidney failure is caused by chronic kidney disease (CKD), it is often irreversible, but if caused by acute kidney disease (AKD) it may be reversed.

Diabetes is the most common cause of CKD and kidney failure, while high blood pressure is the second most common,” he said.

According to him, the number of Nigerians living with kidney disease is far more than these people with kidney failure.

“At St. Nicholas Hospital, Lagos, we see about 120 new patients every year, and an average of 10 new cases every month. Seventy four per cent are male, and 26 per cent are female,” he said.

Worldwide, between 10 and 15 per cent of individuals have kidney failure.

Out of the 25 million with kidney failure, he said about 18, 000 will need dialysis every year (that is about 100 per one million of the population),” the clinical director at St. Nicholas Hospital Lagos, said.

However, getting this dialysis becomes a problem due to the huge cost involved and lack of nephrologists in the country.

“The cost of dialysis is about N30, 000 per session, and the patients need about 3 session per week which is almost N100, 000 per week and about N400,000 per month. Not many Nigerians can afford this and National Health Insurance Scheme (NHIS) covers just three sections of the dialysis.

Also, the nephrologists are very few- we have about 160 nephrologists, which is less than one per one million population and many are located in the urban areas. This is grossly inadequate and unacceptable,” he said.

Aside this, dialysis centres are grossly inadequate and found mostly in the urban areas.

“We have about 149 dialysis centre in Nigeria (both private and public), with about 600 dialysis machines. For a country the size of Nigeria, this is grossly inadequate,” Dr. Bamgboye explained.

This year’s World Kidney Day, which coincides with the International Women’s Day, is celebrated with the theme “Kidneys and Women’s Health.” Because of this, the celebration is laying emphasis on the prevention of kidney disease for all women and girls in the world.

The major cause of kidney failure in women in Nigeria according to Dr. Bamgboye, are hypertension, diabetes and chronic renal nephritis (inflammation of the kidney), which has not been well controlled.

Also, complications arising from pregnancy are said to increase the risk of kidney diseases in women.

“Once you cross 40 years, it is advisable to always go for simple examinations such as blood pressure, blood sugar, urine tests for infections, proteins etc,” he advised women.

“Quite a number of patients we see have topical nephroposis, which is as a result of use of native herbs. Many of the things that cause kidney failure can be treated if detected early. Unfortunately majority of patients with kidney failure present late at the stage, where they need dialysis. There is need to avoid things like bleaching cream, the abuse of analgesic, non steroid drugs and native herbs.”

The nephrologist called on government to focus on health education, early detection and prevention of the disease.

“Also there is need for a screening programme, provision of facilities to make sure that the condition are managed, with affordable cost of treatment. The NHIS can cover more free sessions, from three to thirty six session (three months), while government ensures adequate monitoring of the treatment programme. There is need to reduce the cost of kidney drugs by removing import duties on them,” he added.

On this year’s WKD, the International Society of Nephrology (ISN), has revealed that CKD affects approximately 195 million women worldwide, and it is currently the eighth leading cause of death in women, with close to 600,000 deaths each year.

The risk of developing CKD is at least as high in women as in men and may even be higher. According to some studies, CKD is more likely to develop in women compared to men, with an average 14 per cent prevalence in women and 12 per cent in men.

However, the number of women on dialysis is lower than the number of men. At least three major reasons are recognised so far: CKD progression is slower in women compared to men, psycho-socio-economic barriers such as lower disease awareness leads to late or no start of dialysis among women and uneven access to care is a major issue in countries with no universal access to healthcare,” the group said.