Kidney health for all (II)
I conclude the discussion on World Kidney Day, which I started last week. The theme for 2024 is “Kidney Health for All – Advancing equitable access to care and optimal medication practice.”
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There are five stages of kidney failure, with increasing severity as one moves along the scale. At stage five (also called the end stage or kidney failure), the only remedy is regular dialysis or kidney transplantation to survive. Unfortunately, this is the stage in which most people detect that there is a problem with their kidneys.
Dialysis is the removal of waste products and excess water from the body through artificial means. Without this procedure, these waste products will continue to accumulate in the body, causing serious problems and even death. Kidney transplantation on the other hand involves surgically placing a healthy kidney from a healthy donor into a person whose kidneys have shut down.
After transplantation, the recipient of the kidney takes certain medications for the rest of his life to prevent the body from fighting against the “foreign” transplanted kidney. Sadly, the cost of this treatment is beyond the reach of most Ghanaians, and the Korle Bu Teaching Hospital has started a kidney transplantation programme, but on a smaller scale.
This makes prevention the cheapest method and, hence, the drive for the Ghana Kidney Association to educate the populace about kidney health. As the entire world celebrates World Kidney Day, here are some of the things the government is encouraged to continue to do to improve the care and management of kidney failure in Ghana.
Encourage the prevention of diabetes, hypertension and kidney disease through an innovative programme from the Non-Communicable Diseases Department of the Ministry of Health.
Support the care of patients on dialysis: The cost of one patient undergoing three sessions of dialysis is estimated to be about 120,000 Ghana Cedis per year for treatment. This is beyond the reach of most Ghanaians.
High cost of kidney transplant and legislature: Although kidney transplantation is the preferred treatment, it is expensive and most patients cannot afford it. This notwithstanding, it is important for the government to establish legislation and programmes to make this treatment more accessible to patients with kidney disease. This will make it more cost-effective in the long term, enhance survival and improve the quality of life of patients with kidney diseases.
Limited access to dialysis: Hemodialysis is the most common form of dialysis in Ghana. This type of dialysis is done using a dialysis machine to filter the blood. It is sad to know that few hospitals countrywide have dialysis centres and machines. This limited access to dialysis treatment in Ghana has led to premature deaths among people with chronic kidney disease.
A conscious effort, therefore, must be made to increase the distribution of dialysis centres in Ghana.
Uncontrolled advertisement and sale of certain herbal concoctions: The proliferation of herbal medical centres and their advertisement on our main and social media platforms need to be monitored by the Food and Drugs Authority.
Studies have shown an association between herbal medication and the incidence of kidney disease. Acute kidney injury from the use of herbal remedies is said to account for about 30 to 35 per cent of all cases of acute kidney failure in Africa.
Pollution of soil and water bodies: The pollution of water bodies and our soils has serious effects on our kidney health. As a people, we should be worried about the consequences of “galamsey”.
The continuous pollution of our water bodies with chemicals is linked with kidney disease in people who drink from these water bodies. Some of these chemicals may find their way into plants/foods from these contaminated soils. For instance, the arsenic and mercury used in processing gold have been shown to predispose to kidney disease.
Shortage of trained nephrologists and nephrology nurses across the country: Not all health facilities in Ghana have nephrologists and nephrology nurses to attend to patients with kidney failure.
This situation puts pressure on the few located in teaching hospitals such as the Korle Bu, Komfo Anokye, Cape Coast, Ho and Tamale Teaching hospitals. The main challenge is the huge cost of training these health professionals.
Considering the escalating cases of people suffering from kidney diseases and the worse stage of the disease at presentation, it is recommended that: The government should take steps to include dialysis on the list of treatments covered by the National Health Insurance Scheme.
Just like in Kenya, the government, through the NHIS, should be encouraged to pay for two sessions of dialysis for citizens who need dialysis. Private individuals and corporations in Ghana are encouraged to support the care of kidney diseases in Ghana.
A fund to support the treatment