*Says No. of people requiring dialysis, transplant is just tip of iceberg

By Sola Ogundipe

A Nephrologist and Medical Consultant, Dr Akinsiku Adedamola Oladipupo, has admonished Nigerians who are always feeling unwell, and who get tired easily without  undergoing exertion, to go to the hospital for check up as they might be suffering from undiagnosed kidney disease.

Making the call ahead of this year’s World Kidney Day coming up on March 9, Oladipupo, who diagnoses, treats, and manages acute and chronic kidney problems and diseases, warned that tiredness and general malaise are some of the ways that undiagnosed kidney problems could present to individuals.

“When you see individuals always going to the hospital, and are always complaining of feeling unwell, feeling tired, having malaise, getting tired easily, such individuals might be suffering from kidney disease and we just need to check.”

 Oladipupo, who is also the Medical Director at Doren Specialist Hospital and a Locum consultant for Lagos State Health Regulatory Body, HEFAMAA, described Chronic Kidney Disease (CKD) as a silent killer.

In a chat, he told Good Health Weekly that everyone, irrespective of age, is at risk of chronic kidney disease. 

Silent killer

“It is a silent killer, but most patients do not have direct manifestation or any directly significant or specific symptom initially. But what happens  over time is that they have non-specific symptoms. They get tired easily because it is likely that their blood level is low, and such individuals can end up having difficulty controlling their blood pressure.

“They start to notice that their urine becomes a lot more frothy, as if they put detergent in water. These are ways in which individuals with kidney disease can manifest.”

 Noting that kidney disease is an enigma, the medic said it is a lot commoner than it appears to be. 

“The kidneys produce a particular hormone called Erythropoietin – a red blood cell stimulant that aids the body’s production of red blood cells. In fact it is one of the medications that have been banned for athletes to use because it’s been shown to aid the ability of the cells to carry oxygen.

“However individuals with kidney disease will have a reduction in the amount of erythropoietin that is being produced. Invariably, the amount of red blood cells in their body will be lower than expected and they would get tired easily, and that might be one of the ways they can start to present with kidney problems.

“So when you see individuals always going to the hospital, always complaining of feeling unwell, feeling tired, having malaise, getting tired easily, such individuals might be suffering from kidney disease and we just need to check.

“We also know that chronic kidney disease is a silent killer. It has got different stages, usually stage 1 to stage 5 which is the worst of them all, and that’s the stage 5 individuals, or the individuals with stage 5 chronic kidney disease are just the tip of the iceberg.

“They actually account for about less than one percent of individuals suffering from kidney disease. So you can imagine that the vast majority of individuals suffering from kidney disease are in the community and in the population.

“People that you see coming out on air, begging for alms, pleading for support towards renal replacement therapy such as dialysis, or just the transplant, they are just the tip of the iceberg.” 

Why World Kidney Day

On the World Kidney Day, he said, “The reason why we have every second Thursday in the month of March every year being set aside to mark the World Kidney Day is to create awareness about this ailment that has come to be part of the non-communicable diseases.

“It’s a day set aside to help create awareness about this silent killer, about the way and manner in which it present, and to ensure that individuals tend to screen for it so that we are able to identify this illness early.”

Speaking on the global prevalence of kidney disease, quoted at 11 – 13 percent, Oladipupo recalled a study that he conducted.

Study

“I had  opportunity to carry out a prevalence study in Lagos state in 2015, and the study data showed that about 11.7 percent of adults residing in Lagos state were suffering from chronic kidney disease at that time. Almost 98 percent of them were not even aware that they were suffering this ailment at that time.”

He noted that globally, the commonest cause of chronic kidney disease is said to be diabetes, accounting for about 40 percent of the causes of kidney disease, while hypertension accounts for about 33 percent.

“We have so many other causes which then vary, according to the geopolitical or according to your environment or environmental factors. In this environment, the 3rd most common cause is usually due to obstructive causes.

“There is prostate enlargement, congenital abnormalities, drug abuse, especially individuals that tend to take painkillers a lot. There are also herbal concoction injections commonly called agbo, – these are factors that can all cause chronic kidney disease.

Everyone is at risk

“Everyone is actually at risk of chronic kidney disease, from newborn to the elderly, so it can affect virtually any age bracket. But what I can also say is that as we all age, the risk of developing a chronic kidney disease increases.

“Because of the factors mentioned earlier, the chances of becoming diabetic and hypertensive increases with age. So it makes sense that the causes of chronic kidney disease or the risk factors can increase as age increases.”

“The vast majority of individuals with CKD reside in the community. So you find out that from stage 1 to stage 5, they all still reside in the community, and that’s one of the reasons why the World Kidney Day was actually set aside to create awareness and help individuals detect this kind of disorder early.

“We know that if we’re able to identify individuals with chronic kidney disease early, we’ll be able to do a lot more than we are doing currently,” he asserted.

World Kidney Day is a joint initiative between the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF).

It is a global campaign that aims to raise awareness of the importance of kidneys to overall health and to reduce the frequency and impact of kidney disease and its associated health problems.