Kidney disease is on the increase in Borno and Yobe -Dr Ummate
You recently marked the World Kidney Day in this hospital. What is the logic behind observing the day? We observe the day every second Thursday of March, every year. As part of activities to mark the day, we usually create platforms for awareness campaign on kidney diseases and the causes of kidney diseases and as […]
You recently marked the World Kidney Day in this hospital. What is the logic behind observing the day?
We observe the day every second Thursday of March, every year. As part of activities to mark the day, we usually create platforms for awareness campaign on kidney diseases and the causes of kidney diseases and as how individuals can prevent them.
In general, prevention of disease is much better than treating the disease. This is what we call primary prevention. But even if the disease occurs, there is what we call secondary prevention, that is preventing its consequences including its effects on other systems and organs of the body or prevention of some of it’s side effects. This is what we normally focus on when marking the day.
By way of primary prevention, we noticed that hypertension is the commonest cause of kidney disease most especially in this country and Africa in general. This is followed by a disease we call Glomerulonephritis “GM” (inflammation of the functional units of the kidney). It has a relationship with some bacterial infections and generation of what we call immune complexes (anti-body and antigens complexes in the system). The bacteria that causes immune complexes to be generated attacks specific parts of the body like skin or throat which are present in form of sore throat in an individual. But subsequently, after the infection has subsided, then there is generation of some complexes that are deposited in the kidney which causes the organ’s failure.
The third common cause of kidney failure is diabetes mellitus. This is more common in Europe when compared to Nigeria and other African countries. So, if we say we are trying to create awareness on the prevention of kidney diseases, we mean anybody that is within the age of attaining potential hypertension should be screening himself for the possibility of kidney ailments. Hypertension has age specificity and it starts at the age of forty and above and the incidence increases with age. If you sample people between 40 and 45 years old, you will realize that between 10 and 15 percent of them will be hypertensive. If you go down to about 60 years of age, you will find out that about 30 percent of such people are hypertensive. Therefore, people of the ages mentioned above should always be screened for hypertension and subsequently for the consequences of hypertension, one of which is kidney failure.
What are the symptoms of kidney failure?
What we notice in patients with kidney failure is early morning facial swelling (the face will swell) unlike in other normal people. Then early morning vomiting and lost of apartheid. Subsequently, the entire body will be swollen and excessive weakness of the body will be noticed.
Kidney patients are also intolerant to some exercises which means, they cannot do some activities that they do with ease when they were healthy. This is because of decrease in their blood volume. Example of such exercises is simple trekking.
What is the rate of prevalence of kidney disease in the North eastern part of Nigeria?
Generally, we have found out that kidney disease is very prevalent among Africans. In Borno State, we have carried out a minor research in this hospital about the disease and found out that the prevalence is about 15 percent in the hospital community.
You mean 15 percent of Borno people have kidney disease?
Yes, 15 percent of those who come to this hospital for health care which translates to 15 percent of the catchment area in general and by extension the population. We got the data in 2007 and it was published in 2009. We also found out that even among those who come to this hospital from the catchment areas, significant numbers of the patients are from one community in Yobe State-the Bade community in Gashua. They constitute the largest percentage of the people coming here for Hemodialysis. Out of every one hundred cases of kidney failure that we see in this hospital, you find 20 of them are from Gashua.
We also have few other cases of kidney failure from Katagum in Bauchi State. May be the low rate is because Katagum is much closer to Kano and therefore the patients prefer to go there for treatment. We also have few cases from Wukari in Taraba State probably because the patients prefer to go to Jos in Plateau State or Makurdi in Benue State because of the closeness. We also receive cases from Kaltungo in Gombe State may be because there is the federal medical centre in Gombe. So, generally, most of the cases are from Gashua, followed by the Kanuri dominated areas of Borno State.
Were you able to check the factors responsible for the prevalence of the diseases in Gashua?
Actually we have not done an intensive research to ascertain the cause but we tried and made an attempt and found out that there are certain indicators. In the first place, we tried to see whether there are increasing cases of hypertension among the people, but we realized that it is not correct. The Gashua people don’t have many hypertension cases. Again, kidney ailment is not a hereditary disease. At last, we said the most likely cause is toxin either in their sources of water diet. We have written multiple correspondences to the Yobe State government and the Bade emirate council to give us a mandate and some financial support to conduct an intensive research there but they are yet to respond.
NAFDAC however had done something about five years ago and found out that there is high content of lead (heavy metal) in the sources of water of the Bade people. But for us to be certain about the findings, we have to do Cause and Effect Relationship to ascertain whether the lead is the actual cause of the kidney disease or just it is just a is coincidental finding.
What type of treatments do you offer to kidney patients in this Centre?
In this centre, there are three modalities of treating kidney ailments. We have Hemodialysis, peritoneal dialysis and kidney transplantation. We have done all the three in this hospital but the one we always do is Hemodialysis which entails sieving the blood. It means collecting the infected blood and transmitting it into one machine that will clear all the waste products that are supposed to be cleared by the kidney and then the machine returns the blood back to the body of the patients. We do Hemodialysis all the time and we always have between 20 and 30 people on the roll. Some of them come on Mondays and Thursdays and others on Tuesdays and Fridays. There are two sessions every week for each patient.
However, the actual and correct management of kidney diseases is renal or kidney transplantation. We did this type of treatment only once in this Kidney Centre and we are planning for the second one very soon.
What is the cost of kidney transplant?
We have done the first one free of charge and the hospital management has given us the mandate to do the second and third one free. The waiver includes drugs. To maintain the graft (transplanted kidney), the patient will spend like N3 million for the first two years and subsequently, at least between N200,000 and N300,000 every year.
One important thing you should know is that kidney transplant is cheaper here in Nigeria because to have a successful one abroad, you will need like N4 million in the cheapest hospital. These include transportation and feeding. To have a successful one here, it will not cost more than N2.5 million.
How far have you gone in terms of awareness campaign kidney disease?
In 2008 and also last year, I went to Gashua and presented a paper at the emirate council. Many people attended the session and I also went to the Yobe State House of Assembly and presented another paper. We believe the legislators are the representatives of the people and therefore they would go and enlighten their people.