8 December 2012

Nigeria: Kidney Disease - 32 Million Young People On Danger List

Sokoto, Abuja, Kano — Health experts have raised alarm over increase in the number of young persons with chronic kidney disease (CKD). The figure by the National Association of Nephrology of those currently down with the ailment is frightening. More more worrisome is the revelation that those mostly hit are the young and active segment of the society.

Sunday Elekwa's kidneys are damaged; they can no longer remove waste products from his blood. He has to rely on dialysis machine to stay alive, and he has to do so twice every week at N50,000. For up to four hours a session, the dialysis machine does the job, and will need to do so three times a week to be as effective as his kidneys would have been.

Elekwa has what nephrologists call end-stage renal disease. Elekwa is a young man, and not just him, it include much younger people than he is.

Like Elekwa, Fidelis Putnang, a 27-year-old graduate of the University of Abuja is suffering from the same condition, thus needs money for dialysis forth nightly. Unlike Elekwa, Putnang did not know he is suffering from the ailment until he visited the National Hospital in Abuja after series of malaria and typhoid symptoms.

According to Michael Putnang, his elder brother, "He was shocked the first day he learnt he has kidney ailment. He had regular fever off and on and then later diagnoses to have hepatitis B. It persisted even after treatment, until the kidney ailment was discovered."

Like the two above, millions of young men, experts fear, are living with the ailment. The National Association of Nephrology put the figure of those diagnosed with the ailment at 35 million. Thirty two million out of this number are said to be on danger list, because their kidneys are already failing. The body fears that greater percentage of those currently living with the disease is the active segment of the society. It attributed the rising cases of the ailment among younger people to hereditary and other factors.

"More and more younger population are getting affected," Dr. Kiran Kumar of the Internal Medicine Consultant at Primus Hospital, Abuja told Weekly Trust. He attributed the major causes of this to a "wide prevalence of unidentified hypertension," accounting for nearly 60 per cent of patients with CKD, while also not ruling out HIV and hepatitis B also.

For Dr. Oluseyi Oniyango, Consultant Paediatrician at the National Hospital, Abuja, "lifestyles that young people have adopted over time are also to blame, especially when they become sedentary, engage in little exercise and indulge in sugary, calorie-densed foods that modern conveniences afford.

"There are now younger people who have hypertension and diabetes, which are very important risk factors for developing chronic kidney disease."

In Sokoto State, medical experts said there is rise in the cases of kidney ailment among young population with studies showing that those affected are particularly between 15 and 40 years of age.

Dr. Hamidu Liman, Consultant Nephrologists with the Usmanu Danfodiyo University Teaching Hospital, UDUTH and a lecturer with the UsmanuDanfodiyo University Sokoto disclosed that at UDUTH, they see many patients coming with what they call 'end-stage' kidney disease daily.

"End-stage means that the kidney has totally failed and that the only solution is to temporarily take over the function of the kidney and we have been observing a trend over the last five years and noticed that about 8-10 per cent of all our medical admissions, that means patients admitted into the medical ward, have some form of kidney problem."

He said "in children, the commonest form of kidney disease we see is just simple urinary tract infection then followed by what we call the nephritic syndrome and those that come with chronic renal failure.

The Consultant said recently, they did a small community study as part of the World Kidney Day and realized that evidence for early kidney diseases is also prevalent in the population that they were able to explore.

"We explored people in Sokoto North during the World Kidney Day celebration of March 2012 and realized also that about 15 per cent of the people who appeared at the free screening have some form of evidence of renal damage that means it is a condition that is quite prevalent in the hospital as well as in the community.

"What we noticed from our study is that the young population is affected particularly between 15 and 40 years of age and this is the reproduction age group.

"We are also having a little high incidence of schistosomiasis; it is a form of infection that can also affect the kidney, it is fairly prevalent in children here and it is unrecognized.

"In SokotoState, the weather is fairly hot and people become easily dehydrated and that isalso an important risk factor for the formation of kidney stones."

Dr. Liman said recently, they have noticed the use of herbal medication also is on the rise and that somehow directly or indirectly, it is also contributing to the kidney problem.

Within Sokoto, Kebbi and Zamfara region, Weekly Trust gathered that there are three dialysis centers for people whose kidneys had failed.

In Kano, a physician at the Aminu Kano Teaching Hospital, Dr. Usman Bashir told Weekly Trust that the hospital has recorded kidney related ailments in those below 15 years old, adding that some of these cases were hereditary while others were due to drugs abuses, among other habits.

A relative of a patient undergoing dialysis at AKTH, Alhaji Dauda Suleiman of Hotoro GRA told Weekly Trust that the hospital management has done a great job by relatively reducing the dialysis fee from what the hospital was charging years back. Though he declined mentioning the amount charged, Suleiman said it is affordable to an average salary earner.

So far, AKTH has the best diagnostic and dialysis machines in the state. Similarly, it was gathered that the state owned Muhammadu Abdullahi Wase Specialist Hospital has recently acquired additional dialysis machine as part of the state government efforts in enhancing the hospitals capability and capacity. Though there are other specialist hospitals in the state such as the state Urology Hospital that carter for kidney-related ailments.

According to Dr. Olatise Olalekan , an Abuja-based Consultant Nephrologists and the CEO of Zenith Kidney Center in Abuja, most of the risks factors, especially as they affects young patients are coming from common diseases and social behavior of people in that age bracket,although he affirmed that there is also a hereditary factor.

Among the young patients, kidney diseases associated with HIV/AIDS is more common because of widespread prevalence of the virus among young people. Also obesity, which leads to hypertension is an independent risk factor for developing Chronic Kidney Disease.

"Young people become obese these days which leads to hypertension and also diabetes. All these are risks factors."

He said over- the - counter drugs can also be a risks factor, especially antibiotics and pain killers. Frequent usage of such drugs without experts' advice may cause kidney damage. He also said some herbal concoctions taken without proper recommendation, control or authorisation may also be toxic to the kidneys, causing damages that mark the start of CKD or worsen existing problems with kidney function.

He called for regular exercise to maintain ideal body weight in obese people; non smoking, abstaining from alcohol and drugs abuse; avoiding over-the-counter painkillers; eating healthy and more of natural food, regular kidney and urine tests at least once every year as an antidote to managing the risks."

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