By Chimezie Okwuonu
World Kidney Day celebrated on March 14 every year, is a day set aside by the World Health Organisation to create awareness of kidney disease and its prevention. This year, the theme is, “Kidney Health for All, Advancing Equitable Access to Care and Optimal Medication Practice.”
This year’s theme aims to raise awareness of the inequalities in kidney disease treatment and encourage collaborative efforts to improve access to appropriate treatment for everyone affected by kidney disease.
One out of every 10 adults in Nigeria is at the risk of developing kidney disease. It is one of the leading causes of death among adolescents and adults in Nigeria.
The kidneys are responsible for cleaning the blood and removing the waste products and excess water.
Manifestations of kidney disease include body swelling, vomiting, hiccups, hypertension and lack of blood in the body. Treatment are mainly by drugs, cleaning the blood to remove waste and excess water, a process called dialysis and kidney transplantation; the latter is the definitive cure.
Inequalities in kidney treatment means that people suffering from kidney disease do not have equal access to quality kidney care. While there are ongoing efforts to improve the number of kidney care clinics and qualified personnel globally, not everybody have the financial capability to access quality care. Both laboratory tests, medications and treatment of kidney disease are expensive and out of reach of the common man. Hence, telling someone that he has a kidney disease in our environment creates depression, frustration, deep agony and a road to poverty without regain of health.
In addressing medication practice in kidney disease, what readily comes to mind are poor medication practices that cause kidney disease and these include unregulated consumption of pain killers, consumption of herbal concoctions and other drugs that can directly damage the kidneys. What fuels inappropriate medication practice in our environment is poverty, ignorance and adherence to primitive beliefs even when there are reasons to believe otherwise.
The number of deaths caused by kidney disease is enormous. As such, all hands must be on deck to subsidise kidney care and alleviate the burden and ensure equitable access to care. The current national health insurance agency in Nigeria provides 60% subsidy to only six sessions of dialysis. For a patient going to receive this treatment three times a week for the rest of life, this subsidy is only but a scratch on the surface.
Extending this subsidy to once weekly for the whole dialysis care period will go a long way to solving the problem of inequalities of care in our environment.
In Abia State, the Health Insurance Scheme needs to be expanded to involve more of the formal sector and extend its coverage to involve kidney disease and dialysis.
Secondly, our people need to stop intake of herbal concoctions and imbibe the culture of consulting a health professional to guide drug prescription and intake. Some herbal medications do not have expiry date and are not regulated by the government.
Thirdly, the government has a role to play in implementing policies that will prevent acquisition of drugs without prescription from a doctors, except perhaps some of the routine medications like antimalarials, medications for headache and cold and some pain relief medications.
In addition to the effort made by the Federal Government, each State of the federation can make laws and implement policies that can protect its indigenes from the high cost of treatment of kidney disease. The General hospitals need to be revamped to have equipment to detect kidney failure and initiate treatment.
At the local government level, comprehensive primary health centers need to be equipped with simple tools to screen for kidney disease. These include urinalysis strip and blood pressure apparatus.
At community level, preventive measures such as knowledge and good control of hypertension, diabetes, avoidance of bleaching creams and soaps, reduced transmission of HIV infection, improved sanitation and drinking of clean water will help in curbing kidney disease
In addition, the Nigerian Food and drug administration need to invest in post-approval surveillance of drugs to determine the compliance and restrictive use of NAFDAC numbers to the particular commodity it was approved for.
Most times, the confidence of Nigerian consumers are increased if they see NAFDAC numbers on the drugs or food. In the absence of follow up on use of the NAFDAC numbers, abuse by manufactures and sellers is inevitable.
Furthermore, non-governmental organisations and philanthropists may need to donate funds, materials and machines for kidney care in the community. There are non-governmental entities that have championed the course of kidney disease, especially in northern Nigeria, and few in southern Nigeria. More of such efforts are definitely needed.
This is a clarion call for everyone to join hands to defeat this monster called kidney disease as it has taken an upper hand in the death tolls of our population. A stitch in time, saves nine.
Dr Chimezie Okwuonu is a kidney care specialist.
