High burden as kidney diseases take toll on youth

Four years ago, Joyce Njeri had her lifetime dream within reach with a flourishing business in Nairobi and a happy family. Then life took a brutal turn. In November 2014, Njeri, then 32, delivered safely at Kenyatta National Hospital.

“The delivery went well but it was followed by excessive bleeding which kept me at the hospital for one and a half months,” Njeri told the Standard.

Njeri had suffered acute kidney failure and since then has been on a twice-a-week dialysis. Worse still, she has developed high blood pressure, an inflamed heart and end-stage kidney disease.

“My only hope doctors have said, is an urgent kidney transplant that costs Sh3 million,” she told Sunday Standard.

Unfortunately she cannot afford to raise the funds. Her health condition has already dented the family’s resources even depleting all their savings.

Njeri’s devastating story, is a replica in thousands of homes across Kenya.

A study by Haki Foundation, a charity group, to coincide with World Kidney Day (on March 8) shows most kidney patients in Nairobi County are aged between 21 and 40 years.

While the risk of kidney disease increases with age, the Nairobi study involving 294 patients and 11 doctors and nurses shows increasing kidney problems in young people.

The study in two major hospitals in Nairobi, a public and private facility shows up to 30 per cent of dialysis patients were aged between 10 and 30.

Cumulatively, Ephantus Muhunyo the Executive Director of Haki Foundation says 41.1 per cent of the renal patients in Nairobi County were young adults aged between 21 to 40 years.

Organ donation

“We are talking of lives disrupted at their most productive time. This is a cause for concern,” says Dr Benjamin Wambugu, a kidney specialist with the Kenya Renal Association.

Access to treatment is also an issue for young patients.

Though more than 90 per cent of the study patients were registered with the National Hospital Insurance Fund (NHIF), a significant number have no access to treatment.

“NHIF only covers two sessions while I am recommend for three per week so I have to get Sh7,000 for the extra session,” explains Richard, another patient aged 26.

While doctors recommend three sessions per week, the study shows up to 87 per cent of patients in Nairobi can only afford two.

Additionally, about 53 per cent of the patients did not have a source of livelihood or they were unemployed.

Some patients complain that their employers deny them time away to go get dialysis.

For the few lucky enough to get leave to attend treatment most reported being too tired to go back to work after dialysis hence deemed to be a liability.

The patients, the research say have also to meet the cost of drugs such as for high blood pressure and diabetes which in most cases go hand in hand with kidney failure.

“I spend up to Sh40, 000 per week on drugs to treat various complications,” says Njeri.

So bad is the situation, more than a half of patients in Nairobi say they hold harambees on every week to raise money for treatment.

Wake up at 3AM

But even with insurance coverage or with successful fund raising, getting the weekly dialysis still remains a herculean task.

The researchers found dialysis machines, especially at the public facility are not enough to meet demand while most are broken down due to overuse.

“Patients have to wake up as early as 3.00 am, to get a spot for dialysis,” says Muhunyo.

“You can go up to three days without getting an opportunity to be treated,” says Njeri.

Most of the patients in Nairobi — 57 per cent — have considered getting a kidney transplant but sadly they can’t afford it.

“A transplant is the ideal solution to patients with end-stage kidney disease especially young people who have all their lives ahead of them,” says Dr Wambugu.

However, cost of transplant, lack of organ donor, long queues and uncertainty of outcome are the man barriers for kidney transplant in Nairobi.

NHIF will meet up to Sh500,000 for kidney transplant but will not cover for the required life-long support drugs. In private hospitals, transplant can cost up to Sh2 million.

Njeri, who has been lucky to get her brother to donate a kidney, says her case, like most, is urgent.

“The queue at KNH is too long hence my best option is to travel to India as soon as we raise funds and complete the necessary medical tests,” she says.

In Kenya organ donation remain voluntary and only among relatives. While the Health Act 2017 allows for organs from deceased persons regulations are still being formulated but any commercial organ transaction remains illegal.