Simple steps like regular exercise and routine medical check-up can prevent kidney disease, OYEYEMI GBENGA-MUSTAPHA reports. To mark The World Kidney Day on Wednesday, some experts gathered in Lagos under the auspices of a hospital to sensitize the public on the disease.
Do you know your weight? Weight is not decided by climbing on the weighing scale but through a simple step of conversion: Convert your weight from pounds to kilo-grammes. Your weight (in pounds) ÷ 2.2 = your weight (in kilo-grammes). Convert your height from inches to meters. Your height (in inches) ÷ 39.37 = your height (in meters). Then calculate your Body Mass Index. The result will determine if you are overweight or even obese. If the result indicates overweight or obesity, you need to quickly do Proteinuria test to determine if there is protein-in your urine, so as to avoid kidney disease.
Simple way of calculating BMI in metric is weight in kilo-grammes divided by height in meters squared. Since height is commonly measured in centimeters, an alternate calculation formula, dividing the weight in kilo-grammes by the height in centimeters squared, and then multiplying the result by 10,000, can be used.
The Consultant Nephrologist at Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Prof Fatiu Arogundade, gave this insight at this year’s World Kidney Day with the phrase ‘Run with the kidneys’, held by Cedar Group Hospital in FESTAC, Lagos. The theme was: Kidney disease and obesity.
According to Prof Arogundade, everybody should do everything possible not to get their kidney damaged and it starts with avoiding its causes, and being vigilant on ones urine. “An end stage kidney failure does not occur suddenly, but gradually. If one is conversant with his numbers- Blood pressure, urine analysis, among others and keep his weight down, one can easily prevent kidney disease’’.
For instance foamy urine should not be taken lightly, “A full bladder can make your urine stream faster and more forceful, which can cause foam. The urine can also get foamy if it’s more concentrated, which can occur due to dehydration or pregnancy. Sometimes, the problem is your toilet but protein in the urine is another cause, and it’s usually due to kidney disease. Unhealthy kidneys lose the ability to remove protein waste and it starts to build up in the blood. The condition is often a sign of kidney disease. Healthy kidneys do not allow a significant amount of protein to pass through their filters. But filters damaged by kidney disease may let proteins such as albumin leak from the blood into the urine. So, one needed to run Proteinuria test to be on the safe side. It costs less than a thousand naira,” said Prof Arogundade.
He said kidney disease often has no early symptoms. One of its first signs is proteinuria that is discovered by a urine test done during a routine physical examination. Blood tests will then be done to see how well the kidneys are working.
On how obesity causes kidney disease, Prof Arogundade said BMI under 18.5 – is considered very underweight and possibly malnourished, 18.5-24.9 – you have a healthy weight range for young and middle-aged adults, 25.0 to 29.9 – you are overweight and over 30, you are considered obese.
Prof Arogundade explained that, “Optimal Body weight means the body mass index (index is used to determine if somebody is higher than normal or not). If it is higher than 25kg per meter square that is overweight. Optimal weight is between 20 and 25. If it is higher than 25, and still hovers between 25 and 29.9 we define that patient as being overweight. These set of people are also exposed to the risks of obesity. Those people with BMI above 30 as being obese.”
And the connection between obesity and kidney disease, He said, “In terms of renal failure, people that are overweight have metabolic syndrome like abdominal obesity, impaired glucose tolerance, impaired fasting glucose or diabetes, hyper lipidemia coupled with hypertension. Presence of three or more of these conditions in an individual prone the person to kidney disease, the risk is higher in them than a normal individual. So people that are overweight should watch it and bring down their weight to optimal body weight of achieving a BMI of less than 25kg per meter square.”
To a question on if there is rising cases of kidney disease in the country, Prof Arogundade said the seeming increase in kidney cases incidence in Nigeria is due to increase in awareness and increase in kidney disease cases. “The percentage over the years is still the eight percent we talk of globally. Those that presented to the hospital in community studies across the country are high, ranging from 18 percent of the population to 20 and 26. This is an indication that that kidney disease may be increasing in prevalence in our communities,” he stated.
He advised that to beat down on being overweight or obesity, one should exercise, diet, and avoid excess salt and alcoholic drink.
State of transplant
Prof Arogundade said there are options of dialysis for anybody with kidney disease that cannot be reversed. And should there be need for kidney transplantation; Prof Arogundade said one needs not travel overseas because same is available in the country. St Nicholas Hospital has done about 70 percent of the total number of kidney transplants in Nigeria. A new entrant, Zenith Medical and Kidney Centre, Abuja has done over 50 cases in about two years. Government hospitals doing transplants are not doing well because of financial muscle of the patients, i.e. affordability challenge. Many of the time, the patients aren’t able to sustain the treatment. Those that patronize the private hospitals are rich, while some are supported by NHIS. Aminu Kano Teaching Hospital still transplants fairly regularly, UCH less than a month ago did, like wise OAUTHC but the frequency is a little lower in these hospitals, but with improved government support there will be more transplants.
On life after kidney transplant, Prof Arogundade mentioned that Transplant Association of Nigeria and the Nigeria Association of Nephrology (NAN) are working round the clock to bring down the cost of post immune suppressive drugs. “Recently, the Minister of Health, Prof Isaac Adewole who chaired our conference held at OAUTHC re-echoed government’s feeling of concern of Nigerians dying of kidney failure, so he said by next year, post immune suppressive drugs for kidney patients transplanted in Nigeria will be free. Once this is available, the number of people using expired or near expiry immune suppressive drugs post transplant will be addressed. In countries that are not as rich as Nigeria like Sudan, Egypt post suppressive transplant drugs are absolutely free,” he stated.
Co-founder/Director Cedar Group Hospital, Mrs. Elizabeth Adamma Akpabio said the hospital can assist people with kidney disease get back their life because, “We’ve been in existence since 2001, as part of our corporate social responsibility, we’ve been holding this lecture annually for three years to create awareness about kidney diseases in the community. The incidence of Kidney disease is so high and rampant that we resolved to embark on enlightenment campaign on causes, preventive measures and how to handle by way of knowing where to go for further assessment once the symptoms are there. Our simple intervention through this way has saved a lot of people by reversing their kidney disease status, and others undergoing dialysis or transplant. Some of these people have also gone ahead to spread the information in their abode and places of work as a result of getting the right information through us.”
She added: “We are happy to be in Nigeria operating fully. We are playing a big role by what we are doing thereby reducing medical tourism. India and Dubai come to mind once people want to have surgical intervention but it is mostly Nigerians that are there as the medics. So we are proud that we have good hands here in our hospital, and in the country such as the renowned nephrologists, Prof Fatiu Arogundade. He is usually invited overseas to give lectures and perform transplants. So if we have him here in our midst why then do we need to go out there? Here is cheaper. There is no need for flight for the patient and accompanied relations, or instability with a new environment, also family are around to give their support, so also free accommodation.”
Consultant family Physician/Chief Operations Officer, Dr Chukwuma Ogunbor said Cedar Group Hospital was established in 2010, but the dialysis centre came in 2011. “We are giving back to the community in form of creation of awareness on kidney disease which is a chronic illness. Our charges are surprisingly low compared with others. We do not want people to come down with any end stage, so checking blood pressure and avoiding obesity are some of the ways to avoid developing kidney disease,” he explained.