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Thursday, 8 August 2013

The rising cases of kidney disease and trauma of dialysis

anatomy_Adrenals Kidneys_AnteriorThe increasing cases of chronic kidney disease across all age groups in recent times have been a major source of concern to medical experts. The experts say that unhealthy lifestyles and other neglected health tips largely contribute to the growing occurrence of the disease, particularly among young persons. A study by Prof. Afolabi Lesi and Dr Taiwo Ladapo, both paediatricians at the Lagos University Teaching Hospital, indicates that kidney disease among children accounts for 8.9 per cent of the reported cases of the disease in the hospital between 2008 and 2011. Observers, therefore, express concern about the worrying development, citing the case of Uchenna Emeka, a 13-year-old boy in Abuja, who was diagnosed of renal failure, as an illustration.
Emeka became ill when he was in class six of a primary school and a doctor pronounced that he had entered the end stage of kidney disease two years later. Emeka says that dialysis — the process of cleansing the blood by passing it through a special machine — is quite painful, adding that it takes more than three hours a day for five days.
“I have to drop out of school because I could no longer cope, my parents sold all their plots of land to put me on the treatment, which is very expensive; I always cry for what I am going through’’ he adds.
Dr Dorcas Angbazo, a consultant nephrologist in Abuja, explains that some of the factors that could lead to kidney failure in children include infections, congenital factors and ingestion of toxic drugs, especially herbs, among others.
She, however, says that kidney failure is in stages and could be managed before it degenerates into the “end stage’’ where the sufferers would require kidney transplant or dialysis.
“Dialysis filters the blood and removes excess fluid; this is what the kidneys normally do when they are functioning; a catheter is inserted into one of the large veins in the neck or groin.
“The catheter is connected to the dialysis machine with tubing and blood is removed via the catheter and tubing, cleaned in the dialysis machine and returned to the patient via the catheter.
“This procedure is called hem dialysis but there is another type of dialysis called peritoneal dialysis, in which a catheter is inserted into the abdomen and special fluid is inserted into the abdominal cavity via the catheter.
“The fluid helps to remove toxins and is removed from the abdomen after several hours,’’ she explained.
Angbazo emphasises that kidney failure often occur when the kidneys partly or completely lose its ability to carry out normal functions.
She, however, advises parents against the indiscriminate use of drugs by their children, saying that such practice predisposes them to kidney disease.
She also urges parents to desist from giving their children herbal medicines, stressing that that medicines should only strictly be given to the children, in line with medical prescriptions.
“A lot of parents do not follow the instructions given in administering drugs to children, while some do not consult doctors for diagnosis and drug prescriptions,’’ she says.
However, Angbazo says that uncontrolled high blood pressure as well as inadequate treatment of malaria and hepatitis could also cause kidney disease, adding that tobacco smoking is another causative factor.
The nephrologist, therefore, underscores the need for people to inculcate the habit of checking their blood and sugar level at least once or twice in a year.
Dr Ebun Bamgboye, a consultant nephrologist in Lagos, bemoans the growing rate of occurrence of end-stage kidney disease worldwide, saying that urgent medical action should be taken to reduce the rate.
She also expresses concern over the rising prevalence of kidney disease among the youth, noting that most of the patients with end-stage renal disease usually die due to paucity of funds to undergo regular dialysis, which is very expensive.
Nevertheless, Dr Olatise Olalekan, an Abuja-based consultant physician, stresses the need for diabetic and hypertensive patients to go for regular check-ups to guard against contracting kidney disease.
He insists that diabetes and hypertension are among the leading causes of chronic kidney disease, warning that the therapy of acute kidney disease is very expensive.
Olalekan reiterates that people should make tangible efforts to control their blood pressure, stressing that uncontrolled blood pressure could damage the kidneys and other vital organs.
He, nonetheless, advises people to cut down their salt intake, warning that consuming raw salt increases the likelihood of developing kidney disease.
The consultant also stresses the need for people suffering from diabetes and hypertensive to desist from smoking and drinking alcohol.
Assessing the impact of the disease on the society; observers say kidney failure does not just affect the patient alone, adding that it also affects the entire family members, friends and caregivers.
They, therefore, call on the Federal Government to integrate dialysis into the National Health Insurance Scheme (NHIS) because many citizens cannot afford the prohibitive cost of kidney disease treatment.

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