Expert Seeks Kidney Disease Screening For Employment, Admission

Immediate past national president of the Nigerian Association of Nephrology Nurses (NANN), Ajibike Shanu, has said studies have shown that eight per cent of all medical admission and 42 percent of normal admission in Nigeria are end stage kidney disease.

Shanu therefore called on the government to make legislation to enforce screening for kidney disease prior to employment and school enrolment.

She also clamoured for a ban on smoking and importation of tobacco products, investment in public and private health institution, increase programmes on Non-Communicable Diseases (NCDs), fund population base research on kidney health, provision of subsidized or free treatment for kidney disease patient and strengthen primary healthcare institutions with capacity to diagnose kidney disease, among others.

In an exclusive interview with LEADERSHIP, Shanu asserted that kidney is one of the very vital organs in the body that does tremendous job as it regulates body fluid and electrolyte, blood pressure, remove waste products/drugs from the body, releases hormones that regulate blood pressure and produces an active form of vitamin D that promote strong healthy bone.

She disclosed that when the kidney fails, it will lead to hypertension, as the body will not be able to control the blood pressure. „The body will be unable to regulate the body fluid and electrolyte and very importantly, the amount of water or fluid intake should correspond with the amount of urine output, if not, within 24 hours, patients will manifest signs and symptoms of kidney failure,“ she explained.

On the causes of kidney failure, Shanu said, „kidney failure can happen when a patient lose a lot of blood or body fluid; when diseases like hypertension, diabetes, infection of any source, malaria and cardiovascular disease etc, are not well treated and anything that can cause blockage or regurgitation of urine back to the kidney such as tumor, stone, stricture, adhesion etc.”

On the risk factors associated with kidney disease, she said there are modifiable and non-modifiable factors. Explaining further, she said, the modifiable factors are hypertension, proteinuria, hyperglycemia, smoking, obesity, cardiovascular disease, drugs, high salt consumption, high protein intake, herbal medication, pregnancy and environmental factors such as heavy heat exposure. She listed the non-modifiable factors as age, gender, ethnicity/race, reduction in Nephrons, genetic and other inherited factors such as polycystic kidney disease and low birth weight.

Reducing the human and economic burden imposed by kidney disease relies heavily on preventing the onset and progression of the disease, Shanu stressed, while advocating for more awareness on modifiable risk factors and effort to focus health care resources on those patients who are at the highest risk of developing new onset of kidney disease.

„Primary strategies should include prevention and control of hypertension, diabetes, weight, obesity, high protein diet, herbal medication, smoking and infection, among others.

„Secondary prevention of kidney disease consists of measures for early detection of disease to allow prompt and effective intervention to prevent the development of complications and early detection and treatment of kidney disease, which have been demonstrated to impact positively on the ability and mortality outcomes. Other strategies include, slow progression of the disease through blood pressure control, dietary modification, weight control, early preparation of dialysis, selection of dialysis modality, patient education and canceling and treating pathological process at early stage.

„Tertiary prevention of kidney disease deals with all measures available to reduce or limit impairments and disabilities and to promote the patients’ quality of life. Management aims to prevent complications. The strategies are managing uremic symptoms, fluid management, dialysis, prevention of infection, prevention of cardiovascular disease, prevention of bone problem and kidney transplantation,“ she said.