By Chioma Obinna

Kidney problems have been dubbed a silent killer. The disease afflicts both young and old people alike. From the Lagos University Teaching Hospital, (LUTH) to the Lagos State University Teaching Hospital, (LASUTH) the lamentations of kidney patients are the same — “Treatment is very expensive.”

Kenneth Agbo, a civil servant and one of the kidney sufferers, tells how he has been spending so much on treatment in order to keep living.

“I have been having a hard time managing my health. I know I have high blood pressure and diabetes, but I just cannot resist having a regular meal despite advice from my doctor to stay away from certain foods.

During a checkup, the doctor tested my blood. The results showed I had developed chronic kidney disease.”

Chronic kidney disease

Kenneth wondered if the test results could be wrong because he didn’t feel sick. But his doctor explained that people with kidney disease often do not know it. That’s why it is called a “silent” disease. Kenneth woe began from that day. He can barely pay his rent let alone footing the hospital bill required for dialysis three times a week. “Life became unbearable for me,” he said. Few months later, he could not continue his treatment. His health deteriorated all the more.

Kenneth is not alone. Pa Emmanuel Oyiana, 79, a retired civil servant and Mrs. Oluwatosin Ojejirun, 28 years old, graduate of Linguistic, University of Lagos; have been spending thousands of Naira each week on kidney treatment.

While Pa Emmanuel spends N20, 000, Oluwatosin, spends about N150, 000 on dialysis alone every week. If you multiply these amounts in a month and in a year, the figures run into millions of naira.

Doctors in the theatre

Said Pa Emmanuel:“I spend not less than N10, 000 on two injections to keep my kidneys going. I’m lucky that my kidney problem does not require dialysis. I only spend N60, 000 a month from my pension.

“I retired 25 years ago from the railways. The cost of treatment is very exorbitant. Some people cannot come and take the injections. I know how I source the money at times. There are at times I stay about three weeks to a month because I have no money. Many of us are dying because the hospitals cannot treat without money. Government should implement free treatment for old people; anybody above 60 years should be treated free in Nigeria. And people with such an ailment should be given a kind of discount.”

“I also count my self lucky because there are two categories of patients, those that require injection and those for dialysis. Fortunately, I belong to those that require only injections. The injection is to reactivate the kidneys. There are two injections. One cost N6, 200, and N200 for services charge and the other is about N2, 500 and N200 services charge. “And each visit you must buy them.

It is usually twice a week. But for Oluwatosin Ojajirun life has not been easy after she was diagnosed of the disease 12 years ago. She has been kept alive courtesy of her family, friends and relations. The exorbitant cost of treatment has continued to eat up the income of the husband, parents and siblings. She spends about N150, 000 every week on dialysis.

According to Nathan Foundation 15,000 new cases of kidney failure occurs every year in Nigeria. Statistics have further showed that 30 million Nigerians are suffering from Kidney disease and currently, patients pay as high as N150, 000 for three sessions of dialysis every week and about N5 million annually; costs of transplant varies from hospitals but ranges between N2m and about N3m and a patient needs about N150, 000 monthly to get immunosuppressive drugs after a successful transplant. However, health watchers have expressed worry that a country still battling with a myriad of health issues, kidney disease has remain at the background while patients continues to die without any form of assistance.

Worse still, in Nigeria, kidney failure remains a death sentence if not detected early and managed appropriately. Renal transplant which is key in managing the disease is out of the reach of the poor. The country is far from where it should be in terms of both man power and facilities. There are still too few specialists in treating kidney diseases compare to the burden of patients with kidney disease.

Non availability of many of the facilities that are required to routinely access and treat patients with kidney disease are not readily available within the country and this has remained a challenge for the nephrology and renal community. With such gloomy situations, what then is the hope of survival for kidney failure patients in Nigeria?

A Consultant Nephrologist, Lagos University Teaching Hospital, LUTH, Dr. Bello Babawale however, admitted that kidney failure is expensive to treat any where in the world, but the difference in those countries is that government gets involve in the treatment by introducing a kind of subsidy which is usually up to 80 per cent.

Babawale who lamented the high cost of treatment explained that: “We have unfortunate combination of an expensive treatment for a common disease that afflicts a poor population. The people are poor and the disease is common in the population. The only way is for government to subsidize treatment for kidney failure. Not just transplant but also dialysis and all the other drugs. That is the only way outcome for kidney failure can improve in the country.”

Extra water from urine

“You have two kidneys, each the size of a fist. Your kidneys have an important job. They filter waste out of your blood and remove extra water from your blood to make urine. Your kidneys also control your blood pressure and make hormones that your body needs to stay healthy.”

Further stressing that prevention is a major solution to kidney failure problems; he said subsidizing the treatment would ensure better access to treatment as well as improve outcomes.

On why kidney diseases is becoming more common; he said: “People are having more hypertension, diabetes and those ones are not being properly treated and when they develop kidney disease they are not presenting early to the hospital.”

He said to stem the rising burden of kidney disease, there is need for people to eat good food, undertake regular physical exercise and going for regular medical checkups to sustain healthy kidneys. “For people who are already having hypertension and diabetes, Babawale said the key is to ensure proper control of the conditions. Visit their doctors regularly, take their medicines as prescribed, do the tests that are required and make sure they bring the blood pressure under control.”

He encouraged the population to go to what he referred to as ‘Well people’s clinic”. He posited that since it is a silent disease, “it is good to go to hospital when we are well, even if it is once or twice a year such that you can detect hypertension and diabetes early and institute treatment to control them.” In LUTH alone, 20 new cases are seen by choice from the hospital’s two nephrology out- patient clinics every week. Generally, one or two patients are seen daily.

It is hoped that the Nigerian government will join countries such as Sudan, the US and the host of others, to subsidise kidney fdisease treatment in the country.