Prevention of kidney disease in Nigeria
Dialysis has helped more individuals who have ongoing renal
disease live longer. With proper dialysis care and therapy, it is believed that
people with chronic renal disease can live longer even though their mortality
risk is higher.
Ifeoma Ulasi, President of the Nigerian Association of
Nephrology (NAN), has stated that 25 million people in Nigeria suffer from
renal illness. In light of this new discovery, the president of NAN also
demanded that health systems pay more attention to this potentially fatal
ailment and its efficient treatment.
Considering that March 12 is World Kidney Day, these calls are
both timely and significant.
An initiative of the International Federation of Kidney
Foundations and the International Society of Nephrology is the Annual
International Kidney Day. It is expected that by observing the day every year,
kidney health will be highlighted and renal disease will be brought to
international attention. Kidney Health for Everyone Everywhere is the 2020
campaign's slogan.
Why are
over 20 million Nigerians at risk?
The term "kidney disease" describes damage or harm
to the kidneys that have typically been ongoing for a long period.
A progressive disorder that lowers kidney function is chronic kidney disease, or CKD (basically its ability to filter waste from the blood). Early on in the disease's progression, chronic kidney disease frequently shows no symptoms and therefore can easily go unnoticed by most people.
A person may experience renal failure in this late or severe
stage of CKD, necessitating dialysis or a kidney transplant to preserve life.
An individual with CKD is reported to have lost 85–90% of kidney function at
this point, which is insufficient to sustain life without medical help.
Either end-stage renal disease (ESRD) or end-stage kidney
disease (ESKD) are other names for it (ESRD). Substances that should normally
be filtered build up in the body when the kidneys are not performing their
essential function. The person gets really ill as a result of this. Additionally,
this is when symptoms start to stand out.
Shortness of breath, swelling in the feet and ankles,
cramping in the muscles, nausea, and vomiting are some symptoms that people
report. Frequent or infrequent urine is another. There is a requirement for dialysis
or a kidney transplant to survive after any of the symptoms have been noticed.
Depending on the disease stage, a physician will typically decide which is
required.
The purpose of dialysis is to replace the kidney's natural
functions with a mechanism that filters out waste and surplus fluid from the
blood. At least two or three times a week, for 3-5 hours, a normal dialysis
session will be necessary at a licensed dialysis facility.
Simply described, dialysis is a medical technique carried
out by a nephrologist to temporarily or occasionally permanently take over the
function of the kidneys by removing waste materials, poisons, or excess
electrolytes from the blood, as well as eliminating excess water. Hemodialysis
and peritoneal dialysis are the two forms; the former is more frequently
performed.
The three main causes of kidney diseases in Nigeria are
glomerulonephritis, excessive blood pressure, and diabetes (kidney inflammation
from a variety of causes). Two new top causes of kidney disease for Nigerians
were brought up during the 2019 World Kidney Day celebrations in Nigeria. These
were determined to be toxicity brought on by long-term consumption of
conventional herbal infusions and chemical exposure brought on by long-term
usage of skin-whitening products.
High cholesterol, kidney infections, kidney stones, and
polycystic kidney disease are some of the additional reasons for kidney disease
in Nigeria. In addition, the use of pesticides, contaminated drinking water,
painkiller misuse, and environmental pollution have all been connected to the
development of kidney disease. Noting that there are some high-risk groups is
also important.
Perspective
from a nephrologist
The majority of daily hospital admissions in Nigeria,
according to Moses Tari, a nephrologist at the Federal Medical Centre in Birnin
Kebbi, are due to kidney disease.
All ages and genders are affected, and diabetes and
hypertension are frequently complicated by it. Most patients who need
life-saving therapies and procedures arrive late.
He added that "approximately 40% of referrals to tertiary hospitals are for chronic renal illness. Reviewing the regular admissions to the majority of tertiary hospitals reveals that it is an essentially consistent situation.
The majority of CKD cases, in Mr. Tari's opinion,
"appear when the kidney function cannot sustain a normal living and the
patients needed emergency dialysis to keep alive."
Is Dialysis my last hope
ranging from N20,000 to N50,000 for each session, and the cost
of single dialysis treatment. Notably, three sessions lasting on average
three to five hours each week are the recommended global standard for dialysis.
However, the research described Nigeria's rate of adherence as
"far from the suggested standard."
A kidney failure patient apparently chooses fewer dialysis
sessions because of the cost, sometimes even only once a week. Another study
conducted in Nigeria found that none of the 101 participants in the dialysis
program at the Ekiti University Teaching Hospital could sustain three sessions
per week for a period of three months.
In Nigeria, reports of the end of dialysis are common, and
those who undergo it face major health risks.
The prognosis for CKD patients in Nigeria also appears all too grim given how few tertiary healthcare centers in Nigeria have functioning dialysis treatment capabilities. Unsurprisingly, the majority of CKD patients in Nigeria travel considerable distances between states in pursuit of less expensive dialysis facilities with functional units. Tertiary facilities in several states frequently lack dialysis equipment.
The fact that not many people can resort to transplantation
as a substitute for dialysis further exacerbates everything. In fact, a kidney
transplant costs more than N6,500,000.00.
Request
for action
Despite years of advocacy efforts by the Nephrology
Association of Nigeria and other pressure groups, the Nigerian National Health
Insurance Scheme (NHIS) presently only offers restricted coverage for CKD
patients.
As part of fresh initiatives to consolidate National
Health Insurance, nephrologists, cardiologists, and hematologists are
increasing and coordinating their advocacy to the government at the national
and state level to expand coverage for CKD patients.
In addition, more needs to be done by the government to
inform the populace about kidney disease prevention. On how to safeguard their
health and avoid sickness, there is not much information available to the
general people. This critical area of health promotion requires further effort.
Most young women who use bleaching treatments to achieve a
flawless complexion are ignorant that this can damage their kidneys, and most
people with type 2 diabetes are unaware that kidney disease can develop as a
result. Thus, the main strategy for closing this gap in health promotion.
Nigeria also requires additional specialized technicians and dialysis nurses to fix broken equipment caused by frequent power outages and variations.
Since individuals with HIV and Hepatitis also experience CKD
and might receive dialysis in Nigerian facilities, infection prevention
education and protocol-supportive supervision are essential.
Therefore, we must act as well as commemorate World Kidney
Day in 2020.
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