Kidney failure: silent killer epidemic threatening youths

Emeka Ibemere

A serious youth killer disease is on rampage in Nigeria, and is a generational threatening disease. Many youths have fallen on this silent killer epidemic. The high mortality rate of people diagnosed with Kidney failure is worrisome as its treatment is expensive to carry.

Kidney failure is when one’s kidneys stop working well enough for the person to live without dialysis or a kidney transplant.

 Kidney failure occurs suddenly, and it’s called acute renal failure or slowly over time.  In most cases, kidney failure is permanent. This is called end-stage renal disease or ESRD.

Patients lose nearly all of their kidney function. Dialysis can do some of kidney work including removing extra fluid and wastes, regulating blood pressure, and so on. However, dialysis isn’t an easy treatment even for the fittest person.

The increasing incidence of a chronic kidney disease of unknown aetiology (CKDu) is quickly turning into Nigeria’s latest health crisis, with health experts linking 70 percent of youth’s deaths to renal failure.

Reports say scientists have failed to identify a cause, thwarting efforts to prevent the disease which leads to renal failure, and at worst, death.

Investigation showed that youths of 20-40 years seem to be most at-risk, which has pushed many households to go cap in hand soliciting for funds to have overseas treatment for their wards.

The World Health Organisation (WHO) statistics reveals that the death rate from intrinsic kidney and urinary tract disease was one million in the year 2002; ranking 12^th on the list of major causes of deaths in sub-Saharan African countries, and, indeed, Nigeria.

Experts have said that 36.8 million Nigerians (23 per cent) are suffering from various stages of kidney disease in Nigeria.

A doctor who refused to disclose his name to our reporter claimed that the country suffer few nephrologists. According to him, chronic kidney disease (CKD) affects mainly young adults aged 20–45 years in Nigeria and is primarily due to hypertension and glomerular diseases.

Experts report that the current dialysis treatment rate is 20 per million populations (pmp) (and nil in many countries) in Sub Saharan Africa, with in-center haemodialysis being the modality of renal replacement therapy for the majority.

Transplantation is carried out only in few countries of South Africa, Sudan, Nigeria, Mauritius, Kenya, Ghana, and Rwanda.

Kidney disease has become one of the chronic diseases and it’s expected to take the lives of over 35 million people in 2005, including many young people and those in middle age.

Without action to address the causes, the report say, deaths from chronic diseases would increase by 17% between 2005 and 2015.

According to a health expert, when kidney function level is less than 15%, it indicates that patients’ illness condition has aggravated into Kidney Failure. Dialysis could replace diseased kidneys to eliminate small molecular waste products, such as creatinine, uric acid and urea.

He said from this point, it could be known that dialysis is unable to work as effectively as healthy kidneys. The worse is the longer a patient is on dialysis, the more complications he will have.

This is the situation of beautiful Akinrefon Wuraola Esther, 200 levels of Osun State College of Education Ilesa, and 22 years old Business Education and Secretary Studies’ student. She has undergone treatment for CKDu for the past two years and takes several tablets a day, in three doses and requires constant hospitalization year-round.

She was diagnosed of renal disease in 2014 at the Lagos State General Hospital, Odan Marina on 23 November 2014, latter referred to the University of Portharcourt Teaching Hospital, Portharcourt, Rivers State on December 12, 2014 before moving to Rivon Clinics and Dialysis Centre also in Portharcourt.

She has been at Braithwaite State Hospital Portharcourt since February 10, before she moved to Atinu Critical Care Hospital and Dialysis centre Portharcourt, her current hospital now.

 According to her father, Jide Akinrefon, it takes N30, 000 for a dialysis and is three times weekly.

Newswatch Times gathered that she had had more than 20 sections of dialysis, so far and more still needs to be done. Mr Akinrefon, whose purse has been drained by the disease, said they need N10million, to bring her daughter’s health back.

 Akinrefon begged spirited individuals and organisations to help the family out of the problem. He released an account number-2066903408.

Doctor Awe Albert Olaiye, Medical Director Bishop Awe Medical Centre, 36 Kwaru Family Way Custom Bus stop Abaranje Road, Ikotun,  Lagos , explained that its kidneys that are responsible for clearing of by-products, especially waste products from the body and getting rid of all these waste products is the normal function of kidneys. He said if the removal of these wastes is now impaired; that is what is called kidney failure.

 “When the work of kidney cannot be done how it’s supposed to function, so it becomes a kidney failure. That means the kidney has failed in its function to clear away the waste from the body. Then before we go into why it’s common among the youths, maybe we look into the symptoms of kidney failure”, he added.

“One of the earlier signs or commonest signs that people will notice from that person, is swollenness, which is called idema; the legs will start swollen that means the body is not getting rid of all the water as its supposed to, then the rate at which that person urinates will reduce. He said at least one supposed to pass out water about 2.5 urine every day. Now, water comes out through the urine and then also through sweat”.

According to him, during the raining season when people do not really sweat, the person would pass small urine but during hot season, when the person is sweating more that means, the rate at which that person urinate would reduce, and that such should also be checked.

Awe explains that the rate at which that person urinates was going to reduce, and then if it was not properly managed, the swollen would increase from the legs upwards until that person has swollen face and the tummy too; to the extent that when a finger is dipped on the body of the person, it would go in and would not come up immediately.

“The elasticity would have been affected. Then, there will be pains especially at the back we call it the lumber area, that that is where the kidneys are. Occasionally the person will start urinating something like blood while some will start urinating very concentrated urine because the water is not there, so it is best to manage this kidney failure at an early stage”, he said.

“We have chronic kidney failure, we have acute kidney failure. Acute means it hasn’t lasted, just very short period while chronic means over a long period of time before the kidney will finally pack off”.

On why it is affecting youths rapidly, the Medical Director gave many reasons for it. He explained that what eat, drink and some drugs are the causes of this silent killer disease.

“You see, youths of today are into drugs. When I say drugs, I don’t mean cocaine, marijuana, cannabis or heroine. It’s not compulsory that it must be them, even analgesics, trama, it’s a kind of pain relieving tablet, and the way some undergraduates, and other people use them is abnormal. Instead of 50miligram some can take as much as six or seven tablets grind them and mix it with alcohol and drink”, he explained.

“All these things, they have their effects on the kidney. And antibiotics too, have their own effect on the kidneys and that means they are damaging the kidney little by little. Then, the way people use antibiotics these days are alarming. They go to chemist shop or pharmaceutical shops and buy them and take. Some after having sex with man or woman without waiting, if there is a reaction; so far they have sex without use of condom, they rush for antibiotics as preventive measures”.

According to the medical doctor, his observation of his patients in his hospital has shown that when some patients have malaria, they go for antibiotics like Amoxille to treat malaria instead of going to the hospital.

“Then, this new craze for herbal drinks that are flooding the country and even some tablets that coming into this country. Someone who has tried to look for job all over Lagos and didn’t get and the worse is that this person didn’t go to school talk of passing WASEC, will now go back and start producing herbal drinks and start selling them and people are buying and drinking it.

“You hear all sorts of name, ‘Gonokoka is different from gonoria’ and these boys just start drinking them. Agbojadijadi, sumgbolaja, something bitter, something power, and others are now rampant and the government is not doing anything to it, so everybody is drinking it and it also cause all these kidney damages”, he quipped.

Awe blamed mother of today, who relying on giving new born babies drugs immediately on delivery. He said it contributes to part of the problem on children. Too much drugs like Paracetamol, chloroquine, Ammpiclous, B’codeine, etc help aggravating the kidney failure in the younger ones.

“Then there is another thing, our mothers these days, some as soon as baby is delivered, they will go and buy paracetamol, Chloroquine, and Ammpiclous, every morning as soon as they get the baby, in the morning, they give Paracetamol, chloroquine, Ammpiclous, B’codeine; in the evening the same thing and in the night, the same thing. They continue giving the baby all these drugs and most of these drugs may also damage kidneys and affect all other organs”, he said.

According to him, Paracetamol is not an ordinary drug as people take it to be. He said that it has scientifically proven that Paracetamol aggravates kidney failures.

“So, like Paracetamol, people just look at it as a minor or ordinary pain reliving tablet but you don’t give it for more than three days, because it has a damaging effect on the kidneys and it has scientifically proven”. Awe stated.

“Most antibiotics affect kidneys and some like Eritromacine, Septromacine, and as we notice that the kidneys are not hundred percent okay, we run away from these drugs when we notice that. Most antibiotics, we use them to fight serous case;  we use antibiotics like in the case of typhoid and some sever cases, that we increase it to 10-14 days but some people keep on using these things continuously like that and then, there are also some drugs that doctors don’t really prescribed”.

Most ladies who go for slim induced tablets also runs the risk of fallen to kidney failures through the slimmer drugs they are introduced to and worse was that the drugs are not prescribed by a professional doctor.

“ Like some girls, because they are too slim and would want to add flesh would go and use some drugs to be fatter not knowing that these drugs affects the kidneys and other organs in the body, so there are different drugs but alcohol, the rate at which its being used by youths is also at dangerous level”.

Equally causing the disease is high intake of alcohols by Nigerian youths. Awe said the abuse of alcohol by youths both female and male is on the high side, more serious with recent craze for promotional by brewers and companies that advertises “the buy one take two promos” which increases the level of beer and other alcoholic intakes by youths and asked government to look into these anomalies.   

“The take of alcohol now is on the high side. And worse now is that these companies’ adverts are now targeted at youths. Even in their promos; they are doing it looking at the youths-‘drink one gets two free’ and by these most of them drink more than one bottle, so these are real things. Then, the food we take now and what we eat now is what we see. Nobody is educating us on nutrition again”, he observed.

“Before now the nutrition was okay because then you have missionaries and they always give tips to nursing mothers free of charge and educate them on every anti-natal day on how to educate their children on what they eat. As at that time poverty level was as not high as it is now and that is why even in our house we have daily menu or time table on what to eat but this time around, we just eat anything”.

“Again parents of these days don’t have time for their children any more. For example, parents that wants to leave home by 4.30-5am, what can he or she cooks, its either rice or bread and he or she comes back very late and brings in fast-foods or garri and soup, that is all. So, all these beans, moi-moi, plantain that can nourish the body, mothers are not cooking it for their children any longer”.

According to him, it’s these foods that would nourish the failed kidneys and other organs. He explained that nobody prepares such foods again for their children and that people see fruits as an essential commodity only to be taken during fasting and Ramadan periods.

“Infact now, fruits, nobody eats them unless during Islamic fast or lent season that’s when you can see people taking fruits and this is not good. So if we can improve on our diet and stop taking drugs that are not prescribed by doctors, stop all these concoctions called herbal drinks, stop all high intakes of alcohols, and if one want to take alcohol take it moderately. And people must learn to go to hospital at earlier time, when you notice that your body is not working as it’s supposed to work, report to doctor and allow him to take decision and advice you on what to do”.

On the Federal and state governments’ role to help nip this epidemic into bud, Dr Awe said both governments should embark on sensitisation and education of her citizens on the dangers of the disease. He also said the various governmental agencies responsible for standardising and checking what comes into the country should raise their bar and work assiduously to checkmate the disease among the youths.

“We need more education on this. Again, all these drugs once they are coming in into this country should be checked. Previous governments allowed all sorts of herbal drinks, foods and its only NAFDAC and what it does is just take the thing and experiment it with rats and as long as that rat didn’t die that means its safe for human consumption but if its like unorthodox drugs, we have Standard Organisation of Nigeria, and when you bring your drugs, say valium, they now take it to laboratory and ask how many milligram and they check if it corresponds and if it doesn’t they tell you”, he explained.

“But when the thing is coming into the country as food, there is no Standard Organisation for foods. So, they are now moving these drugs under foods and if NAFDAC, said let anything; if its food, let it pass through laboratory or Standard Organisation of Nigeria, and here the importer will release the contents and all the contents you listed are in the food or they are not more contents as you listed, then they can know what to do. They have to also discourage over the counter drugs”.

He said policy summersault by various governments not to maintain the policy of drugs over counter which causes arbitrary sell of drugs without prescription.

“Government once tried it but after some time the policy just fizzled away. It was that before a pharmacist gives you drugs, he must see the doctor’s prescription but now, nobody is doing that again and I believe its because of poverty; this is because if pharmacist insist on prescription of a doctor and damned the consequences of you not buying from him, he won’t care but in a situation where since one week, he has not sold anything and you come without prescription, he will sell to you, so these are the areas that the government can look into and help reduce the kidney disease epidemic”.