Burden of Kidney Diseases

 Statistics by the Nigeria Association of Nephrology shows that about 36.8 million Nigerians, (23 percent) of the nation’s over 170 million population, are suffering from various degrees of kidney diseases.

An estimated 15,000 new patients are diagnosed every year in the country even as children are now the most hit. In a study conducted between 2008 and 2011 at the Lagos University Teaching Hospital, LUTH, kidney- related diseases accounted for 8.9 per cent of paediatric admissions, with a prevalence rate of 22.3 admissions per 1000 child admissions per annum. Yearly incidence also doubled during the study period.

However, many factors have been adduced to the disturbing trend of the disease. Some include untreated microbial infections, especially urinary tract infections, diarrhoea, malaria, hepatitis, diabetes, hypertension, potassium bromate poisoning, abuse of painkillers/ analgesics, particularly paracetamol amongst others.

Dialysis Centre

The Chief Executive Officer, Kidney Clinics Nigeria Limited, Abeokuta, Ogun State, Mr. Adebayo Sokunbi, who lamented that Nigerian dialysis patients and their families are suffering greatly said out of 120,000 cases diagnosed annually, only 400 patients are on regular dialysis.

In a month, dialysis centres attend to at least 50 persons. Sokunbi said at Kidney Clinics, Abeokuta Dialysis Centre, an average of about 60 sessions are done monthly. “Nationwide, we have no accurate data but most of the centres are in Lagos, Ibadan, Abeokuta, Abuja and Kano among others.

Managing kidney-related diseases is expensive and complicated in Nigeria and even abroad.

For those that are able to afford to seek expert or specialist medical attention abroad, it has been estimated that they spend over N120 billion annually on foreign medical tourism, while about 5,000 patients travel to India monthly for treatment of various diseases, including kidney challenges.

8 GOLDEN RULES OF KIDNEY CARE

What can you do for your kidneys?

Kidney diseases are silent killers, which will largely affect your quality of life. There are however several easy ways to reduce the risk of developing kidney disease.

Keep fit and active

Keeping fit helps to reduce your blood pressure and therefore reduces the risk of Chronic Kidney Disease.

The concept “on the move for kidney health” is a worldwide collective march involving the public, celebrities and professionals moving across a public area by walking, running and cycling. Why not join them – by whatever means you prefer! Check out the events section of the WKD website for more information.

Keep regular control of your blood sugar level

About half of people who have diabetes develop kidney damage, so it is important for people with diabetes to have regular tests to check their kidney functions.

Kidney damage from diabetes can be reduced or prevented if detected early. It is important to keep control of blood sugar levels with the help of doctors or pharmacists, who are always happy to help.

Monitor your blood pressure

Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it is also the most common cause of kidney damage.

The normal blood pressure level is 120/80. Between this level and 139/89, you are considered prehypertensive and should adopt lifestyle and dietary changes. At 140/90 and above, you should discuss the risks with your doctor and montior your blood pressure level regularly. High blood pressure is especially likely to cause kidney damage when associated with other factors like diabetes, high cholesterol and Cardio- Vascular Diseases.

Eat healthy and keep your weight in check

This can help prevent diabetes, heart disease and other conditions associated with Chronic Kidney Disease.

Reduce your salt intake. The recommended sodium intake is 5-6 grams of salt per day (around a teaspoon). In order to reduce your salt intake, try and limit the amount of processed and restaurant food and do not add salt to food. It will be easier to control your intake if you prepare the food yourself with fresh ingredients. For more information on nutrition and kidney friendly cooking, visit our nutrition page

Maintain a healthy fluid intake

Although clinical studies have not reached an agreement on the ideal quantity of water and other fluids we should consume daily to maintain good health, traditional wisdom has long suggested drinking 1.5 to 2 litres (3 to 4 pints) of water per day.

Consuming plenty of fluid helps the kidneys clear sodium, urea and toxins from the body which, in turn, results in a “significantly lower risk” of developing chronic kidney disease, according to researchers in Australia and Canada. The findings, the researchers said, do not advocate “aggressive fluid loading”, which can cause side effects, but they do provide evidence that moderately increased water intake, around two litres daily, may reduce the risk of decline in kidney function. It’s important to keep in mind that the right level of fluid intake for any individual depends on many factors including gender, exercise, climate, health conditions, pregnancy and breast feeding. In addition, people who have already had a kidney stone are advised to drink 2 to 3 litres of water daily to lessen the risk of forming a new stone.

Do not smoke

Smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent.

Do not take over-the-counter pills on a regular basis

Common drugs such non-steroidal anti-inflammatory drugs like ibuprofen are known to cause kidney damage and disease if taken regularly.

Such medications probably do not pose significant danger if your kidneys are relatively healthy and you use them for emergencies only, but if you are dealing with chronic pain, such as arthritis or back pain, work with your doctor to find a way to control your pain without putting your kidne

Discovery could spare patients from kidney transplant

Illustrative photo of an operating theater (photo credit: Nati Shohat/Flash90)

Researchers in Israel and the US have discovered that, contrary to popular medical opinion, the human kidney is able to regenerate itself. Until now, scientists had believed that the liver is the only human organ that can regenerate itself.

A new study by researchers at Sheba Medical Center, Tel Aviv University, and Stanford University shows, for the first time, how the kidney pulls off this trick. Using genetically modified mice, the researchers were able to trace cell growth in the kidney, which reconstituted itself in the proper array of tubes and ducts.

According to US health officials, one in 10 American adults — more than 20 million people — have some level of chronic kidney disease (CKD), which results in reduced kidney function over time.

Kidney disease primarily affects older people, and the problem is growing, according to the National Institutes of Health: CKD now affects more than one-quarter of Americans over the age of 60. At any one time, over 120,000 people are on a waiting list for a kidney transplant, and about 20 people a day die before a suitable donor can be found.

The study is revolutionary in a number of ways, according to Dr. Benjamin Dekel of TAU’s Sackler School of Medicine and the Sheba Medical Center — above all, for what it could mean for the kidney-transplant issue. “Very little is known, even now, about the way our internal organs function at the single-cell level. This study flips the paradigm that kidney cells are static. In fact, kidney cells are continuously growing, all the time,” he explained. If the regeneration process could be speeded up, said Dekel, it could obviate the need for a kidney transplant in most CKD sufferers.

The researchers used a “rainbow mouse” model — genetically developed to give off fluorescent signals in cells — which allowed them to follow the fate of the cells. Using the mouse, the team was able to pinpoint a specific molecule responsible for renal cellular growth, which is known as the “WNT signal.”

Once activated in specific precursor cells in each kidney segment, the WNT signal results in robust renal cellular growth and generation of long branches of cells. To boot, the trio found that the growth was sectional and multidirectional, with each of the nephrons (the filtering tubes that are the basic unit of the kidney) growing at its own pace, complete with its own network of associated tubules, capillaries, and other components.

According to Dr. Dekel: “No one had ever used a rainbow-mouse model to monitor the development of kidney cells. It was exciting to use these genetic tricks to discover that cellular growth was occurring all the time in the kidney — that, in fact, the kidney was constantly remodeling itself in a very specific model. Each part of the nephron is responsible for its own growth, each segment responsible for its own development, like a tree trunk and branches — each branch grows at a different pace and in a different direction.”

With the key to kidney cell growth now unlocked, the next stage, explained Dekel, is to develop techniques to enhance growth, with the aim of enabling a CKD patient to regenerate his kidneys without resorting to a transplant.

“This study teaches us that, in order to regenerate the entire kidney segments, different precursor cells grown outside of our bodies will have to be employed,” added the doctor. “In addition, if we were able to further activate the WNT pathway, then, in cases of disease or trauma, we could activate the phenomena for growth and really boost kidney regeneration to help patients. This is a platform for the development of new therapeutics, allowing us to follow the growth and expansion of cells following treatment.”