Women health

 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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