717,970 Ugandans have kidney disease!!! How healthy is your kidney?

Kidneys are very important to our body as they control a variety of metabolic processes. Kidney has many other important functions to perform in the body which includes flush of the waste materials from the body and controlling blood pressure.

When the kidneys of a person are not functioning properly our body is more prone and more vulnerable and to numerous problems and diseases and some of them are potentially very serious and dangerous.

In Uganda, 717,970 people of 26.3 million were estimated to have kidney disease by the end of 2004, according to the US Census Bureau which has the latest statistics.

The prevalence (new and old cases) of kidney disease is 150 per million people in sub-Saharan Africa. It is estimated that by 2030, more than 70 percent of patients with end stage renal disease will be residents of developing countries, an article published in the New England Journal of Medicine of March 2006 states.

Kidney failure is when kidneys stop functioning properly. There are two types of kidney failure- acute and chronic. Acute renal failure (ARF) occurs when the kidneys suddenly stop filtering waste products from the blood. Chronic renal failure (CRF) develops slowly with very few symptoms in its early stages.

Dr. Kalyesubula says an adult should pass out one and half liters of urine daily. If the amount is less than half a liter, this is an indication that this person is suffering acute kidney injury.
In addition to filtering waste, kidneys keep the balance of salts in the body (electrolytes) to minimize swelling or dehydration. The kidneys ensure that the water balance in the body is right and metabolism is regulated rightly.

Studies show that kidneys release three vital hormones: erythropoietin (EPO), which stimulates the bone marrow to manufacture enough red blood cells; rennin, which regulates blood pressure; and calcitriol, the active form of Vitamin D, which helps maintain calcium for bones and for normal chemical balance in the body.   Kidneys sometimes break down, yet we desperately need them to perform all these very useful functions.

Expensive to treatment
Ugandans with kidney problems who cannot afford to pay 300,000 shillings per visit for a dialysis session three times a week.

Dialysis is a medical procedure in which a person’s body is cleaned of impurities and toxins, a task which his or her kidneys would perform if they were still functional.
This is done using a dialysis machine which acts like an artificial kidney and is used to help the patient get rid of human waste from the body.

Dialysis is an expensive process that costs the patient one million shillings at Mulago and over three million shillings in private clinics each week. The patient requires dialysis twice a day for four to five hours and at least thrice a week.
Currently 30 patients are undergoing dialysis at the renal unit making up between one and two percent of those who badly need the service.

Dr. Bateerana Byaruhanga, Mulago hospital Executive Director says the high fee charged on patients is due to the high costs of consumables used in the dialysis process.
The consumables include the catheter used to draw blood from the patient, the blood line tubes, the artificial kidney used for filtration, jerricans with acid concentrate and bicarbonate powder which form a dialyset that helps suck out the waste from the blood.

Kidney transplants at Mulago Hospital to start in 10 years

Mulago hospital is still facing a huge challenge in treating chronic Kidney failure due to the lack of financial and medical support.
 

The referral hospital has 6 dialysis machines of which only 3 are in working condition. Dr. Eyoku Simon Peter a Renal physician at Mulago hospital says the machines are just enough to treat 30 patients.

Dr Eyoky reveals that the Mulago kidney unit has just two specialist doctors and five nurses serving ever increasing kidney patients.

A kidney transplant is an operation that places a healthy kidney in the patient’s body. The transplanted kidney takes over the work of the two kidneys that failed, and the patient no longer need dialysis.

He says offering kidney transplant operations remain the major challenge facing the treatment of kidney patients in Uganda.

What causes acute renal failure?

Acute renal failure has three main causes: a sudden, serious drop in blood flow to the kidneys. Heavy blood loss, an injury, or a bad infection called sepsis can reduce blood flow to the kidneys. Not enough fluid in the body (dehydration) also can harm the kidneys.

Damage from some medicines, poisons, or infections; most people don't have any kidney problems from taking medicines. But people who have serious, long-term health problems are more likely than other people to have a kidney problem from medicines. Examples of medicines that can sometimes harm the kidneys include: antibiotics, such as gentamicin and streptpmycin.

Pain medicines; such as aspirin, declofene and ibuprofen. Some blood pressure medicines, such as ACE inhibitors. The dyes used in some X-ray tests. A sudden blockage that stops urine from flowing out of the kidneys, kidney stones, a tumor, an injury, or an enlarged prostate gland can cause a blockage.

You have a greater chance of getting acute renal failure if: you are an older adult, you have a long-term health problem such as kidney or liver disease, diabetes, high blood pressure, heart failure or obesity.

You are already very ill and are in the hospital or intensive care (ICU). Heart or belly surgery or a bone marrow transplant can make you more likely to have kidney failure.

What are the symptoms?

Symptoms of acute renal failure may include: little or no urine when you urinate, swelling, especially in your legs and feet, not feeling like eating, nausea and vomiting, feeling confused, anxious and restless, or sleepy, pain in the back just below the rib cage. This is called flank pain.

Some people may not have any symptoms. And for people who are already quite ill, the problem that's causing the kidney failure may be causing other symptoms.

How is acute renal failure diagnosed?

Acute renal failure is most often diagnosed during a hospital stay for another cause. If you are already in the hospital, tests done for other problems may find your kidney failure.

If you are not in the hospital but have symptoms of kidney failure, your doctor will ask about your symptoms, what medicines you take, and what tests you have had. Your symptoms can help point to the cause of your kidney problem.