A senior consultant nephrologist at Apollo Hospitals, New Delhi, India, Dr Devendra Agarwal, has revealed that diabetes, smoking, hypertension and self medication are major factors responsible for kidney damage in Nigeria.
Agawal, who spoke in Abuja to sensitize Nigerians on how to avoid kidney damage, as well as what to do to manage it, said the disease is avoidable.
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According to him, to prevent kidney damage, people should abstain from poor lifestyle, engage in healthy exercises as well as watch what they eat, especially the level of fats in their food.
Agarwal said diabetes has been discovered to be a major cause of kidney diseases as half of the patients suffering from renal failure brought to his hospital for kidney transplant are often diabetic
“Smoking, which people say affects the heart and lungs have been found to be injurious to kidneys too. Pain killers used over a long time can predispose people to kidney damage.
He therefore advised that pain killers should be taken only when they are required. “If we take care of these things, we can cut down the numbers of patients with kidney failure,” he added.
The nephrologist said transplantation and dialysis are the two options often explored to restore a damaged kidney. Dialysis, he said, continues throughout the lifetime of a kidney patient, adding that a patient only gets one kidney in transplant.
“Many patients from Nigeria have undergone kidney transplantation and they are doing fine. Most people who have done transplants do normal jobs and get back to routine life. But, things can be different in the event of donor for transplant. We often advise the patient to continue with dialysis, which is the cleaning of the blood by a machine for four hours. This is required for two or three times a week and it is life-long,” he said.
He said non-compliance of patients to drug prescriptions, especially the dosage, is the main reason for poor outcome of kidney transplant.
“Many patients have reduced the dose or stop it completely because they were okay after their transplant. They forgot that bodies are different and so are kidneys. Therefore, rejection can happen and in most cases, the solution is a second transplant or dialysis,” he said.
He explained that even though patients who undergo kidney transplant can live a normal life, they still have to be subjected to taking medications.
According to him, for a kidney transplant to occur, a kidney patient would need a donor, adding that most patients in Nigeria get their family to donate for them.
“Some patients, who are brain dead may be asked by their relations to donate their kidneys. But this is not so common,” Agarwal said.
“Recently, a family donated a body of their brain dead family member to us. The heart of somebody that is brain-dead still works. We put one kidney into an 18-year old girl and the other into a 55-year-old woman. Both are doing well. But the number of cadaver transplantation is less because families do not give consent for cadaver transplants so easily,” he said.
Agarwal, said experts should test for tissue matching to increase the chances of compatibility before the transplant. “The second thing we do is give drugs known as immunosuppressant to the patients to be taking regularly. It usually starts with a high dose. But later dose reduces,” he said.
The body, he said, can reject a kidney if it is not compatibility or when the blood group does not match that of the patient. “When the blood group does not match there will be rejection. The antibodies also increase and that triggers rejection. When the donor match is positive, we still cannot do a transplant otherwise the body will reject the kidney. What we often do is plasma exchange to take out the antibodies, and when the cross-match is negative, then we do the transplant. Now different blood group renal transplant are possible with the help of plasma exchange and Rituximab, among others,” Agarwal said.
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