‘95% Nigerians with chronic kidney disease die annually due to high cost of treatment’

A Professor of Medicine at the Lagos State University College of Medicine, Ikeja, Olugbenga Awobusuyi, says 95 per cent of patients with severe kidney disease die annually in Nigeria owing to the high cost of treatment.

Awobusuyi noted that the mortality rate of severe kidney disease is high in Nigeria because of a lack of access to treatment.

Speaking with PUNCH HealthWise in an exclusive interview, the nephrologist noted that only five per cent of patients with severe kidney disease survive annually in Nigeria.

Prof. Awobusuyi explained, “There are many reasons why kidney patients die. But the major reason is the cost of treatment. The treatment is extremely expensive at that stage and most people can not afford it. 

“That is why if you look at the survival of most patients with kidney failure in our environment, it’s less than five per cent in a year. 

“Which means, 95 per cent of these patients die because they cannot afford the cost of treatment for kidney disease. 

“That is a rather unfortunate fact. We really need to do something about it in this country. 

“Elsewhere outside this country, they have health insurance coverage for kidney disease. This has helped a lot in taking care of patients who have kidney disease and many other diseases can be taken care of because they have health insurance coverage. 

“But in Nigeria, our patients pay out of pocket and within a short time, they run out of money. This is a very sad situation. It is time for the government to come in and do something.”

According to the World Health Organisation, kidney disease is associated with a tremendous economic burden. 

Giving insight into the causes and rise in kidney diseases in the country, the nephrologist identified diabetes, hypertension and glomerulonephritis as factors responsible.

According to him, diabetes and hypertension are on the increase in the country. 

On the issue of gender and age of those affected, Awobusuyi said, “We don’t have data to suggest that males are specifically more prone to kidney diseases than the females. On the issue of age, if you compare our patients coming down with kidney diseases with those in America, our patients are younger. 

“The older one gets the higher chances of getting kidney disease. But we are seeing a lot of young people with kidney disease compared with what is generally seen in developed countries. 

“This is rather unfortunate because people in their 30s, 40s are the active age group and breadwinners in their families that are meant to be financially stable and these are the people that are coming down with kidney diseases. 

On statistics of the burden of kidney diseases in Nigeria, he said, “We don’t have complete data on kidney diseases.”

However, the Global Burden of Disease 2015 Study by the WHO estimated that 1.2 million people died from kidney failure, an increase of 32 per cent since 2005.

Also, according to WHO, in 2010, an estimated 2.3–7.1 million people with end-stage kidney disease died without access to dialysis.

“Additionally, each year, around 1.7 million people are thought to die from acute kidney injury. Overall, therefore, an estimated 5–10 million people die annually from kidney disease,” says WHO.

The nephrologist noted that the survival and fatality rate of kidney disease depends on the stage, stressing that one can go for dialysis or transplantation at a very severe stage.

According to him, the cost of dialysis is higher in private facilities than in public facilities.

“In some general hospitals, the cost of dialysis per session is between N20,000 -N25,000 while in most private hospitals is between N25,000 – N30,000.

“But dialysis involves more than treating patients with severe kidney failure. You need to take care of their shortage of blood, high blood pressure and other complications,” he said.

The National Health Insurance Scheme, according to him, does not cover chronic kidney disease but takes care of acute kidney injuries.

Awobusuyi noted also that the country does not have enough manpower and public facilities for kidney treatment that are required to cover the number of people coming down with kidney diseases.

He said there are only 15 hospitals in Nigeria that offer kidney transplantation.

“The average cost of kidney transplantation in Nigeria is between N8m -N10m. But it is more cost-effective to have a transplant than to be on dialysis,” he said.

He stated further that it is safer and cheaper to have a kidney transplant done in the country than traveling abroad, urging those seeking treatment abroad to stop looking down on the country’s health system.

He called on those with a family history of kidney disease to go for regular health checks while also advising those with diabetes and hypertension to do the same.

SOURCE: THE PUNCH

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