Kidney problems on the rise as more Kenyans become obese and diabetic

The ratio between kidney specialists and patients in Kenya could be one per 35,714 if the March 2014 statistics are anything to go by.

Government statistics indicate that about one million people in Kenya suffer from kidney disease, yet the country only less than 40 nephrologists, with the Western region, having only one.

That happens to be Dr Michael Owiti, who is also the head of Medical Physiology at Maseno University’s School of Medicine.

“We only have 28 nephrologists in the country and I am the only one in Western region,” he says. “We have one in Nakuru, six in Mombasa and the rest are in Nairobi.”

He adds that lack of nephrologists is posing a challenge to handling the rising number of kidney disease patients since there an increase in the number of Kenyans suffering from diabetes, high blood pressure and obesity, some of the conditions that cause and aggravate kidney ailments.

“Kidney is an organ that fears weight,” Dr Owiti says. “The higher the lipids in the body, the more the kidney functions get messed up.”

According to Kenya Renal Association, chronic kidney disease (CKD) is expected to increase by 17 per cent over the next decade if it is not treated as a global public health issue.

The World Kidney Day, a global health awareness campaign focusing on the importance of the kidneys, notes that high blood pressure causes just over a quarter of all cases of kidney failure, while diabetes causes approximately a third of all cases.

Others are due to infections especially among children and young adults.

The disease is also said to pose a threat to national development as it often results in long term and costly complications.

Dr Owiti is sad that many people consult nephrologists only when they need dialysis after their kidneys have failed.

He insists that their role is not to dialyse but to check the kidney’s health status and prevent people from reaching the end stage. “If the number of dialysis patients is high, it means we are somehow failing,” says Dr Owiti.

He adds that even though there are few nephrologists, they have helped a great deal because when they were fewer, people did not know the magnitude of the kidney disease.

That means there is an increase in the number of those diagnosed. “Initially, people used to confuse the disease with malaria and many died due to ignorance,” he says.

Even then, “most people never bother to find out about their kidneys during routine check-ups and thus any problems get diagnosed when the organ is almost failing or has already failed and it becomes very expensive to

In public hospitals, dialysis costs around Sh 7000 per session, and one needs around three sessions per week.Dr Owiti further says that kidney disease awareness campaigns have not been given priority and there are few dialysis machines in the country, leading to many deaths.

Currently, there are less that 20 dialysis machines at Kenyatta National Hospital and these are used by around 300 patients per day.

Kisumu’s Jaramogi Oginga Odinga Teaching and Referral Hospital and Aga Khan Hospital have nine and three, respectively. “Avenue Hospital has also acquired three machines which should be operational by now.”

The doctor warns those accustomed to using herbal medications.

They should know that they can lead to kidney failure because, unlike conventional medication, herbal medication is not tested and dosage is not controlled.

“I have had patients who used such medication and their kidneys failed,” he reveals. “Many people are dying because of lack of knowledge.”

He says there is high incidence of acute kidney injuries, followed by CKD.

“Acute kidney injuries are always dialysed for about three weeks because the patients come in when they are very sick,” he says. “It kills very fast.”

Many people, he says, have CKD and they do not know because it does not kill easily and one can stay up to five years before death.

KIDNEY TRANSPLANT

The only remedy a patient has after a kidney has failed is either going through dialysis or having a transplant.

Kenyatta National Hospital is the only public facility that offers the latter procedure, which is also performed at the private Aga Khan and Nairobi hospitals.

But it is not all doom and gloom though, considering that African Development Bank has pumped in money to create a Renal Centre of Excellence in Kenya.

It will be a training institution for the larger East and Central Africa.

“The facility will train a lot of people on kidney disease; its management and prevention, dialysis and transplant,” Dr Owiti says.

“When we have such a centre, it will even be possible to have more transplants done outside Nairobi, thus, helping to clear the back log and reducing the number of those on the waiting list.”

KIDNEY DISEASE IN CHILDREN

Amuya Lisa, the Kisumu County Hospital Medical Officer says urinary tract infections, more so in females, should be monitored because the bacteria usually clogs the urethra and leads to urine back flow which can damage the kidney. She reveals that kidney disease can also affect young children. “For the children, most of the time, it is due to dehydration and it is most common among those in rural areas.”

She advocates for sensitisation of hospital staff and the people so that they know and detect the signs early.

She says people should go for screening even when they are not feeling unwell.