How malaria, sore throat can cause kidney failure

Diseases of the kidney are best prevented by regular testing and taking extra precautions to ensure infections such as malaria and sore throat are well treated, reports Sade Oguntola

IT was a rude shock to learn that a mother of three died from kidney failure some few days ago on her way back from a teaching hospital located along the Lagos-Sagamu expressway.
It all started with the pregnant woman experiencing regular feeling of unwellness which her doctor kept treating as malaria and later, typhoid fever. Even after she had her baby, the condition persisted while she also started noticing that when she woke up in the morning her face was puffy.

Mrs. Kemi Akinola’s health problem was not confirmed until four months after she was delivered of her baby. She was diagnosed with kidney failure.

Her husband tried all he could to get her well and spent thousands of naira on medical procedures like dialysis, bought the prescribed drugs and made efforts at seeing if she could have a kidney transplant. But unfortunately, after three months of battling with this predicament, Mrs. Akinola died.

Mrs. Akinola’s case is just one of the several cases of kidney failure now being witnessed in Nigeria. Experts say kidney diseases and kidney failure are now a worldwide public health concern, because the number of people affected is daily increasing and the cost of treatment is out of the common man’s reach.

Dr. Ademola Aderibigbe, a medical expert at the launch of a book entitled “Chronic Kidney Disease in Nigeria: A Handbook for Practitioners and Students of Medicine,” written by Dr. Ayo Arije, described the increasing cases of kidney problems as worrisome considering the importance of the kidney to the body.

According to him, the nature of the disease is such that initially there are no symptoms, thus many patients are unaware of its impending danger.

Dr. Aderibigbe said many reasons have been deduced as causes of kidney problems and that the factors differ in varying degrees in the developed and non- developing countries.

“While in developing countries like Europe, diabetes is the leading cause of kidney diseases, the experience in Africa is different. Major causes are diabetes, hypertension and chronic glomenilonephritis,” he stated.

We are beginning to see hypertension in those between the ages of 18 and 30. This is very significant though information on the number of cases is still very sketchy, but people are attributing it to the use of hard drugs.

“Researches from different centres are however beginning to give us an idea of the problem and also to say that in the future, the volume of cases of people with kidney diseases will certainly increase.

“For many people, unhygienic environment and improper treatment of several diseases like malaria, skin and throat infections at childhood form the basis for their developing kidney problems later at adulthood,” said Professor Adewale Akinsola, consultant, nephrologist at the Obafemi Awolowo University Teaching Complex, Ile-Ife.

According to him, “chronic glomenilonephritis, a major cause of kidney diseases in Nigeria, is due to a number of array of infective agents, from malaria to skin infections in childhood.”

“Many Africans are predisposed to ailments like malaria, sore throat and skin infections. These are rampant and if extra care is not taken to treat them, they could increase their chances of developing kidney diseases that might subsequently lead to kidney failure.

Aside the fact that other diseases such as hypertension and diabetes that ultimately lead to kidney problem and ultimately kidney failure when not properly controlled, he cautioned people on the use of analgesics such as paracetamol and Ibuprofen, as well as traditional herbal concoctions.

“Many people, because of stress and pain consume lots of pain killers like paracetamol which can cumulatively damage their kidney. Also, many of the traditional herbal concoctions are injurious to the kidney, because they contain toxins which on getting to the kidney, may damage it.

Professor Akinsola however said people should endeavour to take adequate amounts of food rich in potassium such as yam and fruits like banana to reduce their risk of developing hypertension. He said “people who eat less of food with potassium are predisposed to having hypertension which ultimately damages the kidney.”

Dr. Ayo Arije, the president-elect, Nephrologist Association of Nigeria, in an interview after the launch of the book at the Paul Heidriskche lecture theatre, University College Hospital (UCH), Ibadan, said other factors that may account for glomenilonephritis in some individuals include worms like larvae forms of loaloa and blood flukes.

Similarly, he said, “soaps and creams containing Mercury are also known causes of kidney diseases,” just as people with kidney stones, sickle cell disease, and many improperly treated infections may also lead to kidney problems. While the exact figures of Nigerians affected are not known, Dr. Arije said at least 10 new cases of kidney problems are witnessed every month, adding that figures from America say at least 50 million Americans will also have it by year 2010.

He said this is a problem that can be prevented if people were screened early for things that point to onset of kidney problems. Early detection ensures that those at risk can be helped. Even bad kidney cases can be prevented from getting worse or the damages reversed.

Dr. Arije said “because awareness on the disease is poor, Nephrologist Association of Nigeria has for some time now taken the first Thursday of every March in the year to create awareness on kidney problems and to do free screening to detect the problem in its early stage so that detected cases can be reversed.”

According to him, “we know kidney problems start early but not detected early and so preventive measures cannot be put in place. The ideal measure is to detect such cases early and preventive measures put in place either to slow it down or arrest it.”

He said such preventive measures are better than having to result in having dialysis or kidney transplant which is very expensive. According to him, a person with kidney failure requires dialysis three times a week at the cost of about N60,000 and if such a person is to have kidney transplant, he or she must have about N5 million. Of course, after the transplant, such a person will still require between N100,000 and N120,000 as maintenance cost in the first one year and subsequently about N60,000.

“All these are pointers to the fact that indigent patients cannot go on far because the cost of treatment is expensive. So the ideal thing is to get it discovered early before the kidney experience totally fails."

Though in Nigeria there are only two places where kidney transplant can be done, Professor Abiodun Ilesanmi, the Chief Medical Director of University College Hospital said by March 2008, it is hoped that the hospital will also commence the provision of services for kidney transplant.

However, prevention of kidney disease is the best. Some preventive measures, Dr. Arije highlighted include:
• Ensuring good blood pressure control.
• Diabetes patients should ensure good blood sugar control
• Indiscriminate consumption of herbal preparations and medications such as paracetamol should be stopped
• Prompt and adequate treatment of infections
• Maintain good toilet and environment hygiene
• No smoking.