Chronic kidney disease and renal failure is a result of a progressive loss in overall kidney function over an extended period. The human kidney has millions of tiny filtering cells called nephrons. If nephron cells become damaged, they eventually stop working, and after some time the nephron cells can no longer filter blood fast enough requiring the aid of dialysis machine. When normal kidney function falls below a certain level, it’s considered renal failure, and despite new technologies that can help treat kidney failure without dialysis many patients ignore the warning signs until it’s too late.
Renal Disease in Sub-Saharan Africa
- Hypertension (High Blood Pressure) affects approximately 28% of the population, and according to the South African Renal Registry (SARR), 22% of those patients end up on dialysis.
- Chronic kidney disease (CKD) is at least 3-4 times more frequent in South Africa than in other developed countries.
- It’s estimated that 15% of patients get CKD due to Diabetes.
- In South Africa, the current dialysis rate is 60 per million population (pmp) compared to less than 20 pmp in other sub-Saharan African countries.
- Transplant rates in South Africa are 9.5 pmp compared to other African countries where the average is about 4.5 pmp
How do South Africans get Kidney Disease?
In South Africa, the two worst offenders of kidney damage are Hypertension (high blood pressure) and uncontrolled diabetes. Other causes of CKD can include being overweight, infections (HIV) where the antiretroviral medications themselves cause kidney problems.
There are three main ways in which patients injure the kidneys.
- “short term” or “acute” injuries are usually due to traumatic accidents such as car crash.
- The second method of kidney damage occurs over a long period. For example, having diabetes results in causing scars to the kidney walls and this gradual injury is known as Chronic Kidney Disease (CKD).
- The third type of Kidney disease is genetic. Diseases such as Polycystic Kidney Disease (PKD), Tuberous Sclerosis and Alport Syndrome affect 5% of South African patients diagnosed with kidney disease.
Who has the highest risk of getting CKD?
Prevention always starts with sensible diets and annual health checkups. Such screening can usually always raise the red flags for those considered “High Risk.” If you know someone with the following conditions then they might be considered high risk of acquiring kidney disease:
- Type 1 or 2 Diabetes
- History of Heart disease: high blood pressure (hypertension) especially if patients have had a previous heart attack or stroke
- Infections: HIV, Hepatitis B/C
- Any congenital disabilities or previous issues in children with bladder or kidneys
- Previous bouts of Cancer — kidneys, bladder, ureter, prostate or cervix. (radiotherapy & Chemotherapy are toxic and can also damage kidneys.)
- A family history of kidney disease
- Age – Especially if over 60 years of age
How to get screened?
Prevention and annual screenings are very simple and easy to do. Most initial health screening and lab tests are not painful or require expensive medical exams. If the initial screening is positive, then the doctor might recommend further testing or refer you to a kidney specialist known as a nephrologist. Ideally, it would be best to get screened at least once a year, even if the previous exams did not reveal any warning signs.
What can patients do they is they get diagnosed with Kidney Disease?
With high-risk patients with hypertension or diabetes, they must first try to control the disease by taking medications regularly and going in for regular follow-up checks. In 2016 the government of South Africa passed legislation to reduce salt intake. This law was a great start of but citizens considered high risk need to take extra precautions to stay healthy by stopping smoking, watch their diet and exercise frequently as these simple steps are proven to lower blood pressure and glucose levels. Late stage renal failure patients are required to have frequent dialysis or placed on a waitlist for an organ transplant. If you or a loved one are considered at risk of getting kidney disease, convince them to be proactive and get screened immediately as this is a crucial first step in the prevention of kidney failure.