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World Kidney Day: Healthy lifestyle, early access to care vital

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World Kidney Day (WKD) is a day set aside by the United Nations to raise awareness about the importance of kidneys to healthy life and reduce the frequency and impact of kidney diseases and associated problems worldwide.

The global campaign is annually observed on second Thursday in the month of March, which fell on March 10, 2022, with the theme — “Kidney Health for All”, focusing on bridging the knowledge gap to improve kidney health through increased care, education and awareness in public arena.

Kidneys are a pair of bean-shaped structures in human body that filter blood and produce urine.

The kidneys also remove waste products and excess fluid from the body, balance minerals and chemicals, control blood pressure, produce red blood cells and maintain healthy bones.

Kidneys are vital to individual’s overall health, so, it is necessary to look after them, keep them in good shape and maintain healthy lifestyle to avoid complications.

Therefore, Dr Habibu Galadanci, a Consultant Physician and a Nephrologist at the National Hospital, Abuja (NHA), advised people to ensure they keep their kidneys healthy for a long life.

Galadanci said that the two bean-shaped organs located in the abdominal cavity of all humans are vital organs and hence, essential for life.

“Their major function is to excrete waste from the body. They also regulate water and salt balance, which are important in blood pressure regulation,” he said.

He explained that there are different types of kidney diseases “but the most common one is what we call Chronic Kidney Disease (CKD).”

According to him, CKD is prevalent globally, as 10-15 per cent of all adults have been found to have Chronic Kidney Disease, including Nigerians.

The consultant said CKD could be due to poorly treated diabetes and hypertension, which are the major causes of chronic diseases.

He identified other causes to include indiscriminate use of both orthodox or non-orthodox drugs, obesity, excessive alcohol intake and cigarette smoking.

He added that “sometimes Chronic Kidney Disease can occur as a result on complications from an inherited abnormality. For example, individuals with sickle cell abnormality can develop CKD.

“Similarly, some inherited cystic kidney diseases can lead to CKD. Sometimes, CKD can be due to immune disorders.”

On symptoms of CKD, he said “this is where the major problem is. It is often asymptomatic and silent in the early stages and only identified when specifically checked for. That is why the issue of health screening or checkups are important.”

He said for those with advanced or late stages of CKD, some of the symptoms are body swelling, especially of the face, legs and sometimes of the whole body, poor appetite, nausea, sometimes vomiting, decrease in the amount of urine and sometimes the urine stops completely.

“Patients may develop general body weakness and difficulty in breathing. Drowsiness, convulsion, lost of consciousness and even death may occur in very severe cases,” Galadanci said.

He said treatment depends on the stage of the disease, and the aim of the treatment also depens on the severity, adding that “for very early stages, the whole aim of treatment is to slow the progression so that the person’s kidney function does not continue declining and gets to a terminal disease.

“Measures to take include adequate treatment of hypertension and diabetes to achieve good blood pressure and sugar control.

“Quitting cigarette smoking, cessation of alcohol drinking, losing weight and regular exercise, decreasing salt and protein intake also help in decreasing CKD progression.

“There are certain drugs we give to reduce the kidney damage and leakage of protein into urine and these are usually given to patients by doctors. There are also drugs to boost the patient’s blood level.

“The aim is to treat the complications that arose from the CKD. This involves giving blood boosting injections to improve the patient’s blood level and some supplements to improve the patient’s bone health.

“There is also the need to reduce acidity in patient’s with CKD, as well as give certain medications to remove excess water that accumulates in the body to reduce swelling.

“However, if a patient presents CKD late or what we call end stage renal disease, then the only option or only way to keep the patient alive will be throughout dialysis or transplant.”

He explained that dialysis is like a blood purifying treatment where the patient’s blood is passed through an artificial filter with the aid of a dialysis machine.

According to him, the patient’s blood is taken, passed through the machinery and returned to the patient. This is done over a four-hour period dialysis.

“This dialysis, however, does not cure the kidney damage, it only does the work of the kidney. So it’s something that has to be done regularly.

“Patients on dialysis need to get dialysis up to three times a week for four hours a day. A lot of time, patients end up doing it once or twice a week because of the big challenge of cost, as a dialysis session costs an average of N25,000 to N30,000.

“Imagine if someone is to have about three sessions per week, that’s about N75,000 to N90,000, aside the cost of drugs and tests the patient has to do.

“The other option, apart from dialysis, which is a better option is transplant, where another person, usually a relative of the patient, donates his or her kidney to the patient.

“However, the challenge to this is that it is also very costly and it is not always easy to get a donor.

“In addition, the patient who undergoes kidney transplant has to take drugs to suppress their immunity so as to avoid rejection. For the body not to reject the kidney, the patient has to take anti-rejection drugs throughout the life span of the kidney.

“But these drugs as well as the operation are expensive and beyond the reach of most Nigerians.

“So, the major challenge in the treatment of end stage renal disease is the cost and because of that, the better option is prevention, early identification and prompt treatment.”

On prevention, he said “our lifestyle is very important so as to decrease the risk of developing hypertension and diabetes.”

According to him, diet is a major factor, saying that one has to reduce the amount of carbohydrate, fat and oil and sugar he or she takes.

“We must try to take a lot of vegetables and fruits, a lot of water and moderate amounts of good protein.

“The good proteins include fish, chicken without the skin, white meat (it is advisable to avoid red meat because of the amount of fat it has; also avoid excess intake of dairy products like yoghurt, ice cream and cheese and generally avoid fatty foods.

“We must also avoid smoking and alcohol and decrease our salt intake. Exercise is very important as it helps us keep our weight down and prevent hypertension and diabetes.

“It improves out heart health, kidney health, general wellbeing and improves the strength and health of our bones too, especially as we get older.

“A minimum of 30 minutes exercise daily will also help a lot, not forgetting regular check up,” Galadanci added.

Another Consultant Nephrologist, Prof. Iftifanus Bosan, also said that early detection through regular medical checks and screening remained the way to reduce kidney disease.

Bosan, a Lecturer at Ahmadu Bello University, Zaria, decried the high cost of treating or managing kidney diseases, attributing that to the major reason many, who could not afford the bills, had lost their lives.

He identified late diagnosis and presentation as causative factor that made cost of managing/treating kidney disease expensive because most cases were presented at its fifth stage.

According to him, if kidney disease is diagnosed early, there are chances that its failure will be prevented for decades, while the patient lives normal life.

Bosan, who identified two types of kidney failures – “Acute kidney and chronic kidney failures”, said “kidney transplant or dialysis cost a lot of money anywhere.

“In my own opinion, the only way cost of kidney disease management can drastically be reduced is if the disease is diagnosed much earlier and treatment starts early.”

He, therefore, urged the public to take care of their vital organs, especially the kidney to stay healthy.

**An Analysis by Abiemwense Moru, News Agency of Nigeria (NAN)

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