More Nigerians will succumb to kidney failure, say experts

• Want enactment of Organ Transplant Act,renal registry
• ‘NHIS should cover treatment’

UNLESS certain measures are taken and quickly too, many more Nigerians may succumb to kidney failure.
A urologist at the Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute in Mumbai, India, Sanjay Pandey who made the dire prediction blamed lack of early diagnosis of diabetes and high blood pressure for the growing cases of kidney failure in Nigeria.

He warned also, that until all the tiers of government critically addressed the infrastructural and manpower deficit in the health sector, Nigerians would continue to seek medical treatment abroad in order to stay healthy.

Also, a team of medical experts led by the President-elect of the Nigerian Association of Nephrology (NAN) and Head of the Dialysis/Transplant Unit and Clinical Director of St. Nicholas Hospital, Lagos, Dr. Ebun Bamgboye, has warned that certain urgent steps need to be taken to prevent more Nigerians from going down with Chronic Kidney Disease (CKD) and End State Renal Disease (ESRD).

The reasons include: persons of black African heritage are four times more likely to develop CKD than people of other races; the prevalence of three major diseases associated with kidney failure –hypertension, glomerulonephritis and diabetes – is on the rise in the country; growing indiscriminate use of herbal concoctions, bleaching creams and soaps, alcohol, hard drugs and smoking; increasing number of persons living with Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) and low socio- economic status of most Nigerians -that is low Gross Domestic Product (GDP) associated with high CKD burden, among others.

Most common is Glomerulonephritis, a type of kidney disease in which the part of human kidney that helps filter waste and fluids from the blood is damaged. The following may increase risk of this condition: blood or lymphatic system disorders; exposure to hydrocarbon solvents; history of cancer and infections such as strep infections, viruses, heart infections, or abscesses.

To address the situation, the medical experts recommended among other things that government should urgently look at how to improve the socio economic status of Nigerians; ensure good sanitation and literacy; enact a solid Organ Transplant Act; establish a National Renal Registry and Kidney Transplant Programme; extending the National Health Insurance Scheme (NHIS) to support patients with kidney failure; regular public enlightenment sessions; development of data bank for disease donor transplant; subsidy of some sorts for immunosuppressive drugs.

Other members of the team include: Eminent Urologist and Transplant Surgeon at Fortis Hospital, Bangalore, India, Dr. Mohan Keshavamurthy; Consultant Nephrologist and Medical Director Ibadan Hypertension Clinic, Emeritus Professor Oladipo Olujimi Akinkugbe; Professor of Medical Microbiology and Provost, College of Medicine, University of Lagos (CMUL), Prof. Folashade Tolulope Ogunsola; Professor of Forensic Pathology and Vice Chancellor, Lagos State University (LASU), Prof. John Oladapo Obafunwa; former Lagos State Commissioner for Health, Dr. Jide Idris; former Ogun State Commissioner for Health, Dr. Olaokun Soyinka; and Medical Director of St. Nicholas Hospital, Dr. Dapo Majekodunmi.

Meanwhile, in an interview with The Guardian in Port Harcourt, Pandey identified the two common problems that bring about kidney failure among Nigerians as diabetes and hypertension.

According to him, these are epidemiological diseases of modern era mainly associated with a patient’s life style issues.
“So diabetes and hypertension are the commonest hammers or disaster for the kidney in the long term. Anybody who is having diabetes or hypertension for 10 years or more with key and satisfactory control, will still suffer microscopic injury of the kidney that will be happening regularly,” he said.

According to him, kidney treatment is not a treatment of choice in Nigeria due to lack of infrastructure as a result of which patients are left with the only option of dialysis which is a temporary treatment that does not result in a permanent cure .

Pandey advocated a boost in the medical infrastructure of the country and the improvement in the capacity of the doctors so that patients could easily get renal replacement therapy, which is beyond dialysis that merely happens to be a stopgap.

The urologist who is also an expert in robotic surgery, kidney cancer treatment and transplant recommended that persons suffering from kidney problem, prostrate, urinary leakages and blockage should never postpone their urinary treatment to avoid compromising their health further.

He urged Nigerian doctors to begin to network with their colleagues around the world to help Nigeria prevent some diseases like hypertension and diabetes , both lifestyle diseases that give the patients long-term disasters that can never be reversed.

For him, because India has been able to invest heavily in the area of medical infrastructure and has some of the best medical training in the world, it has become a destination for medical tourists drawn mainly from countries like Nigeria, Europe and the Americas.

According to him, except Nigeria invests heavily in medical infrastructure, patients from the country will continue to seek better treatment outside for succour from diseases they have been suffering for so long.
“I use robots to carry out surgery which may not be happening in Nigeria and many parts of the world. Nigerian patients who can afford the relatively cheap medial expense in India will continue to go there because they want to live healthy lives and not die everyday of what some local doctors will I say ‘I cannot treat you.’ That is not the end of the world,” he maintained.

On his part, Bamgboye said: “We need to start looking at our socio- economic status. We need to ensure good sanitation and literacy. There is an urgent need to enact a solid Organ Transplant Act. There is the need for us to have a renal registry, which does not exist in Nigeria at present. I know government is looking into it but we have to make sure that it should be able to provide for the less-privileged members of the society. There is absolutely no reason why the National Health Insurance Scheme (NHIS) should not be extended to support patients with kidney failure.

We need to cooperate more. We need to have regular public enlightenment sessions. We need to develop data bank because we should be looking at disease donor transplant in the near future.
“More importantly, there is the need for subsidy of some sorts for some of the drugs that are used, which are quite expensive. In Sudan once you have a transplant the government provides you with the drugs for free plus other support. There is no reason why we should not be able to do that in Nigeria,” he said.