Really depressing news came out of celebrations to mark this year’s World Kidney Day recently. We heard that 17,000 new cases of kidney disease are diagnosed in Nigeria every year but that only 2,000 of these have access to life saving kidney dialysis. Consultant Nephrologist Dr Ebun Bamgboye, who is also the Clinical Director of St. Nicholas Hospital, Lagos said Nigeria has one of the largest burdens of kidney disease in the world. He said this during a screening/awareness exercise organised by St. Nicholas Hospital for schools in Lagos.
Dr Bamgboye, who is a former president of the Nigeria Association of Nephrology, said factors that predispose people to kidney disorder are common in this country, with hypertension and diabetes topping the list. He said, “In Nigeria it is estimated that every year the incidence of kidney disease is 100 per 1,000,000 people. The number of new cases of kidney failure we see every year in the population of 170 million is 17,000. If you put all the patients on dialysis across the nation, they are less than 2,000. If 2,000 people only are on dialysis and 17,000 need it and when you don’t get it you will die, you can imagine the number of people dying because they don’t have access to dialysis.”
As if the foregoing revelation was not bad enough, Dr Bamgboye said in spite of the huge number of Nigerians with kidney disorders, the country is faced with a dearth of kidney disease experts. He said in Nigeria the ratio of nephrologists to patients is 1 to 1million. This depressing news should be enough to draw the attention of both the federal and state governments of the impending crisis facing the country if urgent steps are not taken to manage this disease. Previously, patients with kidney disease had to travel abroad for treatment if they can afford it but it is commendable that in the past decade, many state governments across the country have established dialysis centres in various teaching and specialist hospitals. These are however still not enough to cope with the kidney disease epidemic that we have on our hands.
There is also the problem of cost. Kidney dialysis is costly, up to N20,000 per session in some private clinics and a patient must undergo it several times a month or even a week. Most of the state governments that have established kidney dialysis centres subside the cost, to as low as N5,000 per session. This cost is still prohibitive to a poor patient who may forgo some sessions due to the cost, which in turn imperils his health and worsens his condition.
A large percentage of our population is as yet not covered by the National Health Insurance Scheme (NHIS). Even for those who are covered, there are some diseases that the scheme does not cover, and these are the most costly ones. That is why we support the call by Dr Bamgboye for extending the period of dialysis under the NHIS from six sessions (two weeks) to 36 sessions (three months). At least it would offer some relief to patients and their relatives. With diseases of modern lifestyle on the increase there is need for the authorities and experts to look at windows on how to extend some treatments under the scheme.
In the long run the old adage ‘prevention is better than cure’ applies very properly in this case. Government and health experts should collaborate and embark on massive awareness campaigns and tell citizens what to do to avoid kidney disease, since treating it is very costly. As it is, many people are into self-medication, particularly using herbs, which Dr Biodun Osibamowo, a Consultant Internist also at St. Nicholas Hospital warned against, saying it has been discovered that local herbs are a major cause of kidney disease in Nigeria.
People need to be
constantly reminded about this great danger facing us, and not only on
World Kidney Day.
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