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It is worrisome that the country is experiencing a rise in cases of kidney disease and failures. It is therefore advisable that people maintain regular checkups, have access to regular, affordable healthcare, in order to get those checkups and eat right, while the government should formulate national transplant policies that will increase the availability of kidneys for transplant in the country.
By Anthony Isibor
MARCH 12 each year has been declared as World Kidney Day, WKD, to reverberate on the importance of the kidney and the need to care for it.
The theme for this year’s World Kidney Day, “Living Well with Kidney Disease” suggests that the current status quo in kidney disease management and treatment aims to prolong longevity by preserving, restoring or substituting kidney function and delivering relief from kidney failure regardless of the efficacy for the overall kidney disease management
According to the World Kidney Day Steering Committee, as found on the WKD website, “The disease-centric approach may be inadequate as it does not satisfactorily reflect patients’ priorities and values.
People living with kidney disease tend to, above all, want to be able to live well, maintain their role and social functioning, whilst maintaining some semblance of normality and a sense of control over their health and wellbeing. The status quo approach also removes patients’ agency as they lack meaningful involvement in the management and treatment of their disease.
“This, in turn, leads to patients frequently perceiving treatment as being imposed, punitive and out of their control. For patients to be more content, engaged and constructive with regard to their treatment, and thereby improving clinical outcomes, they need to feel that their symptoms are effectively managed and to be intrinsically motivated to become active participants in their treatment. Ensuing life participation is equally important for both patients and their care-partners, as opposed to feeling consumed and constrained by the current approach to treating kidney disease.
This has been done in order to both increase education and awareness about effective symptom management and patient empowerment, with the ultimate goal of encouraging life participation.
The kidneys are a pair of bean-shaped organs, about 4 or 5 inches long, located on either side of the spine, below the ribs and behind the belly.
As an organ that filters the blood, they remove wastes, control the body’s fluid balance, and keep the right levels of electrolytes. All of the blood in the body passes through them several times a day.
Each kidney has around a million tiny filters called nephrons. Report has it that one could have only 10% of the kidneys working, and not notice any symptoms or problems, thus the need to constantly care for it.
Being diagnosed with kidney disease can be a huge challenge, both for the patient and those people around them. Its diagnosis and management, particularly in advanced stages of kidney disease, impact severely upon their lives by reducing their ability, and that of family and friends, to participate in everyday activities like work, travel and
socializing whilst causing numerous problematic side effects – e.g. fatigue, pain, depression, cognitive impairment, gastrointestinal problems and sleep problems, among others.
It is estimated that as at 2019, more than 37 million Americans were living with chronic kidney disease and almost 750,000 Americans were dealing with the stark reality of end-stage renal disease, ESRD, because their kidneys no longer function well enough to sustain life on their own.
As an organ that requires more and more attention, the American Government in July 2019, announced the Executive Order on Advancing American Kidney Health outlined national goals for improving kidney care, helping the overburdened kidney transplant system meet patient needs, and providing treatment options, including the development of a bioartificial kidney.
Commenting on the condition, Lynda Frassetto, MD, a UCSF emeritus faculty member, physician trained in nephrology, and clinical researcher, over her 30-year career she has both cared for kidney disease patients and published more than 100 research papers on how to improve treatments and outcomes for them, said that vast majority don’t even know that they have a kidney problem because there are typically no or few symptoms in the early stages of the disease.
“Most of these patients have diabetes and high blood pressure. Kidney disease is really a spectrum of disease that starts at one end where you appear fine, but have some kidney damage and progresses to the other end where there’s no kidney function at all.
“At this last point, you have what’s called end-stage renal disease. By the time you progress to this point, the kidneys are no longer working well enough to do their job – to clean your blood and clear your body of excess water and other toxins that accumulate in your body. If we don’t put you on dialysis at this point, or if you don’t get a kidney transplant, you’ll die,” she said.
The most important thing is, therefore, regular checkups with your primary care provider. When people develop kidney failure, in general, most people have no idea, because it doesn’t hurt. And so, the kidneys can silently get worse and worse and worse.
Just as it is in America, the level of kidney malfunctioning n Nigeria also calls for concern and requires urgent stringent measures both medical and legislative, to mitigate against this medically treatable condition that has continued to cut short the life’s of both the young and the old.
In an interview with the News Agency of Nigeria, NAN, Dr Ojeh Oziegbe, Consultant Nephrologist, expressed his worry over the rising cases of kidney disorder in Nigeria, stating that the ailment has become a nationwide concern.
“The last population studies we did in a nearby village showed that close to one-third of the public are beginning to have kidney problems and that is a terrible figure.
“I have been more or less with this kidney unit since it started around 1999 and at that particular time, we probably diagnosed three or four patients a day.
“But what we have now is that in UBTH at times, we diagnose between 10 and 13 a day.
“A lot of people are now becoming hypertensive at a younger age and that causes close to half of the number of kidney diseases that we have,” he said.
He added that the cause of kidney malfunction is largely a matter of lifestyle, and attributed the rising number of kidney cases to unresolved infectious diseases like hypertension and diabetes, according to him are a risk factor for kidney diseases.
“Our Western lifestyle is a major player, while excessive intake of sugar or sweet things encourage diabetes to increase and that causes kidney damage.’
“Use of drugs is on the rise especially the ‘feel-good drugs.
“In Nigeria, there’s this habit that is very common, when they finish working in the evenings they come home and tell the chemist to give them a mixture of five to seven drugs.
“They take those and they feel happy because they feel stronger.
“But it causes cumulative damage on the system,” he added.
Different experts from various fields of medicine have commented on the care and treatment of kidney disease.
Lynda A Frassetto, a health specialist, notes that there are only three kidney treatment options available to patients at the point when the kidneys cease to function, or at end-stage renal disease.
“There are only three today. One, the patient refuses dialysis and sadly will die. Two, we put the patient on dialysis. Or three, the patient receives a transplant from a living or deceased donor.”
However, Christopher Freise, an organ transplant surgeon at UCSF Medical Center believes that transplant, like dialysis, is not a permanent solution.
According to him, “Kidney transplants will remove patients from dialysis, but unfortunately, kidney transplants fail over time.
“About half of kidneys from deceased donors fail after 10 years, with living donor kidneys lasting nearly twice as long.
“Once the kidney fails, return to dialysis is needed. Some of those initial transplant patients may be candidates for another transplant. For those patients who remain on dialysis, the average life expectancy is five to 10 years, depending upon their health status and how well they’re able to adhere to their treatment plans. But there are dialysis patients who have lived much longer,” he said.
Adding that although a Kidney transplant remains the optimal treatment for suitable candidates with kidney failure, the ability to provide this life-saving therapy to everyone with kidney failure is still limited by the organ supply.
David Quan, transplant pharmacists, pharmacotherapy, treating a patient with drugs as opposed to, procedures like surgery or radiation, says that Safe, effective pharmacotherapy is difficult in any patient, let alone a transplant patient.
“Most adults take about four or five prescription drugs a day, and that doesn’t count the Over the Counter, OTCs drugs – the vitamins and supplements. Most people don’t keep a medication list.
He also added that “some medications can affect kidney function, while other medications and even certain foods can affect the transplant medications that the patient must take.
“Even over-the-counter medications can be an issue in patients with kidney disease. For example, the common, over-the-counter medication ibuprofen – brand name Motrin or Advil that’s often used for headaches, aches, and pains – can affect kidney function.
“Patients with kidney disease shouldn’t use these types of medications, as they can worsen kidney function.
There can also be complicated interplays of various medications the patient is on, and certain medications can also be toxic to the kidneys and should be avoided if possible. As well, there are also some life-saving medications that can actually cause kidney failure.
“Genetic factors may also influence how much of certain medications to use in the transplant patient. Other medications may influence drug levels, and these must be considered to ensure the appropriate amount in the body – not too little and not too much,” he said.
Due to the elusive nature in the treatment of kidney diseases, it is highly advisable that people maintain regular checkups, have access to regular, affordable healthcare in order to get those checkups, eat right, exercise regularly, and maintain a controlled weight, while the government is advised to formulate national transplant policies that increase the availability of kidneys for transplant.
– July 31, 2021 @ 16:58 GMT |
Tags: affordable healthcare Kidney Disease Kidney Disease: Experts advocate regular checkups
