What are the rate of occurrence and the percentage of increase in cases of kidney failure in Nigeria at the moment?
Patient with chronic renal failure who ultimately require renal replacement therapy abound in Nigeria. The prevalence of the disease is estimated to be at least, twenty times as high as in developed countries. Chronic renal failure account for 7-12 percent of medical admission to our tertiary care centres.
So, what in your study was found to be responsible for this increase?
The prominent causes of kidney failure in Nigeria include hypertension and diabetes. This disease is the leading cause of mortality and morbidity among young male adult Nigerians aged between 25 to 40years in their economically productive years and thus constitutes a rip-off on the economy.
Professor Wale Akinsola, heads of the Renal Unit of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, told SEMIU OKANLAWON that with increasing cases of kidney failure in the country, the government alone cannot be left to provide for the center established to cater for patients.
What are the option for treatment?
There is renal transplantation which is the outright replacement of the malfunctioning kidney. But this is offered to a very limited extent by three hospital (two public, one private) and the total capacity is less than 30 transplants per year against a patient population of about 5,000 to 10,000. There is what we call haemodialysis. Our haemodialysis centre was opened in 1989 with four machines which soon became obsolete and ineffective and were replaced with five machines in the last five years. A total of 554 patients comprising 140 with acute renal failure and 304 chronic renal failure had benefited from this faculty. And to circumvent the problems posed by technology and the high cost of haemodialysis, our centre embraked on what we call Continuous Ambulatory Peritoneal Dialysis. Our experience has shown that CAPD is easily practicable in the rural setting and will therefore provide access to treatment to a lots of our patients and therefore, promote, the government policy of taking health care to the underserved rural populations at the primary care level. But this is also hampered by unavailability and high cost importing CAPD fluid and other consumables used for the strategy.
Now, to what extent is the country equipped to tackle this scourge?
Well unfortunately, our centre is greatly constrained by poor infrastructural development, unavailability of ancillary but very critical services such as tissue typing facilities. The constraint on this facility include high demand by the increasing patient load, poor infrastructure such as electricity, water, high cost of consumables and others. The cost of a dialysis session has increased from N700 in 1989 to N7,000 to N8,000 per month to N80,000 to N100,000. So, less than five per cent of the patients needing dialysis treatment can afford it for a minimum duration due to high cost. Tissue typing machine is the one used to determine the compatibility of the person who is donating a kidney for replacement.
With the cost of treating kidney problems with all the available options, what has been the experience as far as the patients are concered?
Because of the poverty in the country, you find out that most of the patients find it difficult to afford the cost of either kidney transplant, haemodialysis or even the CAPD which was deviced by us to avoid the problem of the other methods. This hospital has been subsidizing the cost of kidney transplant to the tune of millions. And the problem now is that we can no longer provide the kind of support we had provided these patients again. The centre itself needs to be assisted by philanthropic Nigerians. The point is that the cost of taking kidney failure patients abroad is so enormous. If we have this centre here, what we only require is for the wealthy Nigerians to come forward to assist in putting this centre on a good footing.
So, how much is the centre shopping for to ensure its smooth operation?
We have put our needs at N141.25million. This will take care of our needs in the areas of community outreach for renal care services, diagnostic support services, kidney replacement, haemodialysis maintenance of equipment, staff training and retraining and many others. Apart from the government, individual and corporate organizations have a lot to do in this respect. This centre should be a pride to all of us in this country, but fund is our major problem.
Because of the poverty in the country, you find out that most of the patients find it difficult to afford the cost of either kidney transplants, haemodialysis or even the CAPD which was devised by us to avoid the problems of the other methods. This hospital was been subsiding the cost of kidney transplant to the tune of millions. And the problem is that we can no longer provide the kind of support we had provided these patients again’
source: The PUNCH, Monday, November 10, 2003 page 15