Drug abuse, refined foods worsen chronic kidney disease

Director Cedar Group Hospital, Mrs. Ada Akpabio; flanked by Prof. Solomon Kadiri of University College Hospital (UCH) Ibadan (right); and Dr. Akinsiku Adedamola of Cedar Group, at the Kidney Lecture organized by the Cedar Group and Association of General and Private Medical Practitioners of Nigeria, Ojo Branch at FESTAC, Lagos

Director Cedar Group Hospital, Mrs. Ada Akpabio; flanked by Prof. Solomon Kadiri of University College Hospital (UCH) Ibadan (right); and Dr. Akinsiku Adedamola of Cedar Group, at the Kidney Lecture organized by the Cedar Group and Association of General and Private Medical Practitioners of Nigeria, Ojo Branch at FESTAC, Lagos

•As Cedar group, experts advocate early diagnosis, treatment support policy
Chronic use of painkillers and regular intake of oily foods for years can have a directly damaging effect on the kidneys, leading to the need for dialysis or transplant at the cost of several millions of naira.

Experts, who made this disclosure, fingered persistent use of common painkillers and over-the-counter drugs that lead to kidney failure (a serious condition in which the kidneys fail to rid the body of wastes) in unsuspecting patients.

Consultant Nephrologist at the University College Hospital (UCH), Ibadan, Prof. Solomon Kadiri, said that the drug-related damage, coupled with prevalence of non-communicable diseases like hypertension and diabetes, now account for high prevalence of kidney problems that is fast assuming an epidemic proportion among Nigerians.

Kadiri, among others who spoke at a recent 2016 World Kidney Day commemoration, organised by Cedar group of Hospitals in Lagos, hinted that the myriad of predisposing factors are not helping local intervention to address the problem.

With changes in lifestyle, diet and more of non-communicable diseases, coupled with longevity, more Nigerians tend to come down with both acute and chronic kidney conditions, he said.

Also, a Consultant Nephrologist at the National Hospital Abuja has blamed the increasing rise in kidney diseases on the consumption of refined food, dairy product and oily food.

The expert who stated this during sensitization walk to mark World Kidney Day in Abuja attributed the rising incidence and prevalence of kidney disorder on over dependence on western lifestyle and over dieting.

Speaking on the theme of the day is “Kidney Diseases and Children: Act Early to Prevent It,” he said such practice encourage obesity thereby leading to diabetics and hypertension he said, “The rising incidence of kidney, particularly chronic kidney disease, in our country which also reflected globally is due to Westernisation; we have taken up western lifestyle which comes up with diseases.

“These diseases were previously not as common as we have them today just like diabetics and hypertension which are the commonest causes of chronic kidney diseases. The main thing is diet; we have abandoned our traditional diet of vegetables and fruits.

“We have taken up a lot of sugar, refined food, dairy product and oily food which encourages obesity and further lead to diabetics, the major cause of chronic kidney diseases. We should adopt general healthy living which has to do with diet, we need large amount of vegetables, fruits, moderate carbohydrate, chicken and fish, minimal amount of dairy product,’’ he said.

Kadiri, a former president of the National Association of Nephrologists, explained that some of the commonly useful drugs in the class of antibiotics, painkillers and others with prolong use are fast showing up as risk to the kidney (nephrotoxic).

The worst part about kidney damage is that in the initial stages no symptoms are seen. As kidney failure progresses, the following symptoms may be evident: pain in the back; below the rib cage; vomiting and nausea; swelling of hands and feet; anaemia; dizziness; loss of appetite and weight loss among others.

“If you feel that the need for painkiller has dragged on for too long, and then you need to see your doctor,” Kadiri said.
Imperative of early screening, intervention

“Because kidney injury could be there and one may not know, then that raises a lot of questions on screening. The injury could show itself only when it is quite late and too late to do more.”

He advocated that all adults, particularly those with one communicable disease or the other, family history of kidney disease and those over 60 years should be screened regularly.

Children, both at birth and after three years should also be screened. “The reason is that some of them are born with kidney disease because something had gone wrong with the foetus and there are many reasons for that. It is so important because there are some certain diseases that can be taken out early otherwise may lead to the patient having kidney failure in the early years of life.”

He urged Nigerians to be wary of predisposing risks to kidney diseases, warning that the treatment is quite expensive in a clime that does not have an organised system that could either provide or support patients for such treatments.

Going by another estimate that no fewer than 36.8 million Nigerians, being 23 per cent, are suffering from various stages of kidney disease in Nigeria, it implies that at least one in every seven Nigerians have some form of kidney disorder. And of every 50 patients in need of dialysis, only one gets it.

On how government can come in, he said: “first, the widespread knowledge is important and the need to empower hospitals to be able to detect the diseases in the early stages and treat them. Also, it is important to manage those conditions that cause kidney disease – hypertension, diabetes and many infections. Government, through insurance schemes should massively invest into this. Such that if patients need dialysis, it would not have to come from their pockets.

“Cost of dialysis for one month might well be in excess of N100, 000. And it goes on indefinitely, unless one goes for a transplant, which is in millions. Even after the transplant or shortly after, one may need to spend up to N100, 000 a month to keep the transplant from failing,” he said.

Managing Director of Cedar Group of Hospitals, Dr. Adedamola Akinsiku, stressed that the only way forward is screen the patients early and be able to institute measures to correct the anomaly.

His words: “Most of the patients that we see in the hospitals are just a tip of the ice berg. They are just a small fraction of the magnitude of people with kidney diseases. We know the financial implications of late detection. Most of them cannot afford it, no matter how financially buoyant they are.

“Renal transplant cost around seven or eight million and they will be on drugs for the rest of their lives. The best bet for everybody is to detect kidney illnesses early and then we could reduce the number of patients presenting at late (end) stage.”

“We need the government intervention in kidney treatment, to subsidize haemodialysis and made it readily available. It could come in through the National Health Insurance Scheme (NHIS). It does, the country will be better for it,” Akinsiku said.

Galadanci said that management of kidney diseases was very expensive, urging Nigerians to guard against things that would expose them to such ailment. He advised Nigerian adults to go for annual check-up for blood pressure and sugar.

Furthermore, he urged the children to utilise the opportunity of entering primary, secondary and tertiary institutions to test their urine for kidney disorder. According to him, such measure would go a long way in addressing the disease from the scratch before it generate to kidney failure and dialysis, among others.

“The most important thing is to try and prevent patients from getting to kidney failure which is too expensive for them to afford. The best thing is to prevent it, identifying the risk factors. Identifying chronic disease before it progresses to kidney failure is a major step.”

“Nigerian children should use the opportunity of entering schools; primary, secondary and tertiary to do that pre-school medical check, at least test their urine for nephritis,’’ Galadanci said.

Chairman, Nigeria Nephrology Association, Abuja Branch, Dr. Zike Tada, urged government to assist in the reduction of cases of kidney failure, adding that such assistance geared toward subsidizing or make kidney diseases treatment and dialysis free, among others.

He said that the association decided to focus on the children this year because the disease is no respecter of anybody.
“We are focusing on children because we want to catch them young. People are ignorant of it; they do not have the knowledge and understanding of the causes, and preventive measure of kidney in the country.

“Kidney diseases are preventable if you eat healthy diet, reduce salt consumption and avoid excessive weight gain, among others,’’ Tada advised.

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