30 November 2008
As alleged baby killer teething medicine, 'My Pikin', continues to wreak havoc in the country, Sunday Vanguard sought the views of a consultant nephrologist, Dr Toyin Amira of Lagos University Teaching Hospital (LUTH), on the possible nephrotoxic element in the syrup and future implications on children that survived after administration of the medicine.EVEN though I am not sure if the drug, 'My Pikin', has been analysed, it must contain a nephrotoxic chemical which, when taken, is injurious to the kidney. Anybody who takes it just comes down with acute kidney failure. I suggest that 'My Pikin' teething syrup should be analysed seriously.
There must be a very toxic chemical within it causing kidney failure because, many years ago, we had the same problem with Paracetamol syrup in Ibadan which they used diethyleneglycol, instead of propyleneglycol, to mix. Diethyleneglycol is very toxic to the kidney.
A killer drug?
There must be something in that teething powder that is toxic to the kidney. Like I said, the kidney excretes drugs and toxins and some of these things are concentrated in the tubals of the kidney that can cause kidney damage. It contains a chemical which must be toxic, that is why all the babies came down with acute kidney failure and died.
The implication on the children that survived is that they may have sub-clinical kidney damage. Sub means that it may not manifest in symptoms of kidney damage; the kidney may not function optimally but still good enough to live a normal life. For many babies that have survived and recovered kidney functions, they may not have any problem because we are dealing here with acute kidney failure.
Acute kidney failure is reversible but for those who survived there are two options, either they recover complete functions or they have some minimal underlying damage but they are fine.
In acute kidney failure, once you recover, you have recovered unless you develop conditions that will predispose you to kidney failure or you take a drug or something that is injurious to the kidney.
But if those babies grow up and they are normal, they are not diabetic, or hypertensive and they don't have other conditions that can predispose them to kidney damage, they will live normal life because that is the difference between acute and chronic kidney failure. In acute, you recover function; although small percentage of them may have scars in their kidneys, they have enough function to live a normal life.
On self medication: I think parents should be mindful of what they give their children.You don't just go on the shelf and pick up anything to give to your children. Parents should shy away from drugs that are not prescribed by medical personnel. I think this My Pikin thing must be basically on prescription from friends and relatives. People have to be careful in indulging in self-medication but always seek medical advice.
On incidences of kidney failure in Nigeria: We have a problem in Nigeria because we don't have community-based data. Most of the data we project is hospital-based. But the prevalence is from two to per cent percent hospital admission to the medical ward.
This is just an estimate because a lot of people don't get to hospital before they die but the new cases we see is put at 100 per million population and if we say we are 140 million in Nigeria, it translates to about 14,000 per annum.
But the prevalence which is both the old and new cases is estimated to be 240 per million population. We have over 50 dialysis centres scattered across the country. When you put together the number of individuals on maintenance dialysis, it is very appalling. It is about 300 to 400, so what happens to the others?
According to global projection, the rise in kidney problem is not peculiar to Nigeria alone. It is a global thing. In the 1990s, we had below 500 million people on one form of kidney replacement treatment or the other but, by 2000, it had risen to1.5 million and it is projected that it will rise to 2.5 million by 2010 due to increase in the number of hypertension and diabetes because they are the leading causes of kidney failure all over the world.
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