With the recent revelation that the number of Nigerians suffering kidney-related disease is on the increase, EMMANUEL ADENIYI, in this piece, examines the disease and the roles of counterfeit drugs as a factor predisposing many in the country to renal failure.
WHEN former President Umaru Musa Yar’Adua’s sickness became a common knowledge and was discovered to be acute pericarditis, a disease which experts said could have developed from renal failure, not many people, including nephrologists, gave him any benefit of survival.
Pericarditis is believed to cause poor blood flow to the body, including kidney, thus causing its failure.
In fact, a medical doctor, who claimed to have done several nephroctomies for patients, even asked in a published article, at the peak of controversy surrounding Yar’Adua’s ill health in 2010 that, “when a man’s kidney begins to malfunction, how long can he live?”
He was categorical in his analysis and expressed doubt about the chances of the former president’s survival.
Though attempts were made to save his life as he made trips to some of the best hospitals in Germany and Saudi Arabia, the former president eventually lost the battle against pericarditis.
Yar’Adua’s widely reported illness is one in millions of sufferers of kidney-related diseases in Nigeria. Some are aware of their ailment, a great number of them, due to their poor living conditions; however, do not seek medical attention to ascertain the level of the ailment in them.
According to the statistics recently released by the National Association of Nephrology, about 30 million Nigerians are said to be suffering from kidney problems, while many are said to die prematurely of cardiovascular diseases which are also linked to kidney malfunctions.
The president of the association, Dr. Chinwuba Ijeoma, was reported to have dropped the bombshell that no less than 20 per cent of Nigerians have kidney problems. Right now, the number of new patients seeking dialysis every month in the nation’s teaching institutions are said to range between 200 and 300.
A nephrologist, Dr. Adetuberu Samson of Olive Hospital, Ibadan, who spoke on the prevalence of this disease in Nigeria, attributed it to abuse of drugs and self-medication among Nigerians.
Said he, “This disease is often prevalent among people who abuse drugs and take drugs without doctor’s prescriptions. Though there are other factors that induce it, chief among them is misuse of drugs. The figure quoted recently is likely to multiply, because of the free access to drugs in the country.”
Another medical expert, Dr (Mrs.) Janet Orji, said the disease was rampant in the country because of the prevalence of fake and expired drugs often used by many in the country to cure various ailments.
She blamed the government and its drug monitoring agencies for not doing enough in mopping up and arresting criminals who always import or manufacture and sell fake drugs in the market, noting that many chemist shops in the country operate illegally.
“When you use drugs that are fake or expired or adulterated, they have the capacity to work negatively on your kidney. Human kidney does a lot of work, when it is impaired by phoney drugs; it becomes difficult for it to perform its regulatory roles in the body.
“Kidney helps to excrete wastes from human body and in the re-absorption of water, glucose and amino acid. It also serves as a natural filter of blood in humans. You can then imagine what will happen in the body if the organ responsible for these vital duties becomes incapacitated.”
“Counterfeit drugs are on the increase in the country. This portends a great danger to the health of the nation, because a large percentage of our people purchase drugs over-the-counter, while some even take herbs whose chemical compositions they do not know without consulting their doctors.”
She noted that most herbs taken by many Nigerians could harm human kidneys and liver and cause cancer, high blood pressure, kidney stones, stroke, coma and even death.
A pharmacist, Mr Bolaji Adewuyi, disclosed that most drugs in Nigeria have their chemical components either altered or adulterated. He said it was worrisome with the way many fake drugs find their way into the country, adding that one of the negative effects of using fake or adulterated drugs is to develop kidney-related diseases.
He decried the upsurge in the opening of chemist shops in almost every nook and cranny of the country, adding that most of these drug outlets are mere slaughtering slabs where counterfeit ( fake, adulterated and expired) drugs are sold to members of the public.
According to a public health analyst, Dr. Adeyinka Kayode, poor health facilities in the country have similarly worsened the cases of the disease, saying many patients of kidney-related diseases don’t have access to adequate medical attention.
“A visit to department of Nephrology in many teaching institutions in Nigeria will convince anyone that available facilities for the diagnosis, dialysis and kidney transplants in patients are not enough. In most cases, they are non-existent, this is why many kidney disease patients are transferred abroad for treatment,” he said.
On what Nigerians could do to stem the tide of the disease, Dr. Kayode said they should avoid taking pills from questionable sources, urging them to always adhere to doctors’ prescriptions before using any drugs.
According to the National Kidney Foundation of Michigan, taking safety tips by individuals before using pills are instructive. It states that to prevent kidney diseases in humans, people must not take any drug or substance without a medical reason or take pills given to them by a stranger or even a friend.
It urged them to also avoid the use of over-the-counter medications for more than 10 days for pain or more than three days for fever, and read the warning label before using over-the-counter medications, stating that if they have pain or fever for a longer time, they should see a doctor.
The foundation further warned, “Avoid prolonged use of analgesics that contain a mixture of painkilling ingredients. If you are taking analgesics, drink at least six to eight glasses of water per day. Use the nonsteroidal anti-inflammatory drugs (NSAIDs) only under your doctor’s supervision if you have heart disease, high blood pressure, kidney or liver disease or if you take diuretics (water pills) or are over 65 years of age. Make sure your doctor knows all prescribed and over-the-counter medications and herbs you are taking.”
Pericarditis is believed to cause poor blood flow to the body, including kidney, thus causing its failure.
In fact, a medical doctor, who claimed to have done several nephroctomies for patients, even asked in a published article, at the peak of controversy surrounding Yar’Adua’s ill health in 2010 that, “when a man’s kidney begins to malfunction, how long can he live?”
He was categorical in his analysis and expressed doubt about the chances of the former president’s survival.
Though attempts were made to save his life as he made trips to some of the best hospitals in Germany and Saudi Arabia, the former president eventually lost the battle against pericarditis.
Yar’Adua’s widely reported illness is one in millions of sufferers of kidney-related diseases in Nigeria. Some are aware of their ailment, a great number of them, due to their poor living conditions; however, do not seek medical attention to ascertain the level of the ailment in them.
According to the statistics recently released by the National Association of Nephrology, about 30 million Nigerians are said to be suffering from kidney problems, while many are said to die prematurely of cardiovascular diseases which are also linked to kidney malfunctions.
The president of the association, Dr. Chinwuba Ijeoma, was reported to have dropped the bombshell that no less than 20 per cent of Nigerians have kidney problems. Right now, the number of new patients seeking dialysis every month in the nation’s teaching institutions are said to range between 200 and 300.
A nephrologist, Dr. Adetuberu Samson of Olive Hospital, Ibadan, who spoke on the prevalence of this disease in Nigeria, attributed it to abuse of drugs and self-medication among Nigerians.
Said he, “This disease is often prevalent among people who abuse drugs and take drugs without doctor’s prescriptions. Though there are other factors that induce it, chief among them is misuse of drugs. The figure quoted recently is likely to multiply, because of the free access to drugs in the country.”
Another medical expert, Dr (Mrs.) Janet Orji, said the disease was rampant in the country because of the prevalence of fake and expired drugs often used by many in the country to cure various ailments.
She blamed the government and its drug monitoring agencies for not doing enough in mopping up and arresting criminals who always import or manufacture and sell fake drugs in the market, noting that many chemist shops in the country operate illegally.
“When you use drugs that are fake or expired or adulterated, they have the capacity to work negatively on your kidney. Human kidney does a lot of work, when it is impaired by phoney drugs; it becomes difficult for it to perform its regulatory roles in the body.
“Kidney helps to excrete wastes from human body and in the re-absorption of water, glucose and amino acid. It also serves as a natural filter of blood in humans. You can then imagine what will happen in the body if the organ responsible for these vital duties becomes incapacitated.”
“Counterfeit drugs are on the increase in the country. This portends a great danger to the health of the nation, because a large percentage of our people purchase drugs over-the-counter, while some even take herbs whose chemical compositions they do not know without consulting their doctors.”
She noted that most herbs taken by many Nigerians could harm human kidneys and liver and cause cancer, high blood pressure, kidney stones, stroke, coma and even death.
A pharmacist, Mr Bolaji Adewuyi, disclosed that most drugs in Nigeria have their chemical components either altered or adulterated. He said it was worrisome with the way many fake drugs find their way into the country, adding that one of the negative effects of using fake or adulterated drugs is to develop kidney-related diseases.
He decried the upsurge in the opening of chemist shops in almost every nook and cranny of the country, adding that most of these drug outlets are mere slaughtering slabs where counterfeit ( fake, adulterated and expired) drugs are sold to members of the public.
According to a public health analyst, Dr. Adeyinka Kayode, poor health facilities in the country have similarly worsened the cases of the disease, saying many patients of kidney-related diseases don’t have access to adequate medical attention.
“A visit to department of Nephrology in many teaching institutions in Nigeria will convince anyone that available facilities for the diagnosis, dialysis and kidney transplants in patients are not enough. In most cases, they are non-existent, this is why many kidney disease patients are transferred abroad for treatment,” he said.
On what Nigerians could do to stem the tide of the disease, Dr. Kayode said they should avoid taking pills from questionable sources, urging them to always adhere to doctors’ prescriptions before using any drugs.
According to the National Kidney Foundation of Michigan, taking safety tips by individuals before using pills are instructive. It states that to prevent kidney diseases in humans, people must not take any drug or substance without a medical reason or take pills given to them by a stranger or even a friend.
It urged them to also avoid the use of over-the-counter medications for more than 10 days for pain or more than three days for fever, and read the warning label before using over-the-counter medications, stating that if they have pain or fever for a longer time, they should see a doctor.
The foundation further warned, “Avoid prolonged use of analgesics that contain a mixture of painkilling ingredients. If you are taking analgesics, drink at least six to eight glasses of water per day. Use the nonsteroidal anti-inflammatory drugs (NSAIDs) only under your doctor’s supervision if you have heart disease, high blood pressure, kidney or liver disease or if you take diuretics (water pills) or are over 65 years of age. Make sure your doctor knows all prescribed and over-the-counter medications and herbs you are taking.”
Corruption is the cause of counterfeit drugs in Nigeria--Professor Olutayo
Professor Alebiosu Christopher Olutayo is a Consultant Nephrologist and Provost, College of Health Sciences, Osun State University, Osogbo. He speaks on kidney diseases among Nigerians. Excerpts:
ACCORDING to the National Association of Nephrology (NAN), no fewer than 30 million Nigerians are said to have kidney problems. What do you think could be responsible for this?
Kidney problems are common, harmful and treatable but now occur in an epidemic manner globally. A huge variety of diseases can affect the function of the kidneys, from acute illnesses to drugs and chronic illnesses. Common causes of Chronic Kidney Diseases (CKD) include inflammatory diseases of the kidney, infections, obstruction in the urinary tract and inherited disorders like polycystic kidney disease. But in both developed and developing nations diabetes and hypertension are becoming the most common causes of CKD. The well-recognised risk factors for CKD include diabetes mellitus, hypertension, family history of kidney disease, cigarette smoking, and abnormal fat in the blood (dyslipidaemia). Others include exposure to heavy metals such as lead, low birth weight (with a reduction in the number of nephrons), and the use of herbal remedies, particularly in Africa. In Nigeria, the commonest causes of chronic kidney diseases are hypertension, glomerulonephritis, diabetes mellitus, and obstructive uropathy.
With the frightening figure released by the association, does it not mean that the nation is losing the battle against kidney disease?
No, the battle is not being lost; rather it calls attention to the gravity of the problem. Government may not be doing enough in respect of addressing the problem of kidney diseases in Nigeria. Non-communicable diseases (which account for the greater majority of the causes of chronic kidney diseases in Nigeria) have become a major health problem, not just in developed countries but also in developing countries. For instance, the prevalence of hypertension in Nigeria is between 15 to 27.7 per cent and studies have shown that blood pressure control rates are poor. It is, therefore, not surprising that hypertension is still the leading cause of CKD in Nigeria. A lot is needed to be done to fight the war against the rising occurrence of CKD.
What does it mean to have kidney failure or kidney-related disease(s)?
The first consequence of undetected Chronic Kidney Disease (CKD) is the risk of developing progressive loss of kidney function leading to kidney failure and the need for dialysis treatment or a kidney transplant. The second is premature death from associated cardiovascular disease. Individuals who appear to be healthy who are then found to have CKD have an increased risk of dying prematurely from CVD (coronary disease, stroke, peripheral artery disease, and heart failure).
Could self-medication be a cause of kidney problem in the country? If yes, how?
Nigerians should refrain from consumption of medications without prescriptions. Certain habit like the chronic use of pain killers, especially the group known as non-steroidal anti-inflammatory agents, is associated with the development of chronic kidney disease.
Can poverty and poor health care system in the country contribute to the rise of the disease in the country?
Health is recognised as an essential component of human development. Many Nigerians still live below the poverty line and do not have good and adequate access to health care. In sub-Saharan Africa, there is a double burden of diseases- infective diseases (such as malaria, gastroenteritis, pneumonia) co-existing with the non-infective diseases, in a resource poor environment characterised by inadequate and moribund healthcare delivery systems. Unfortunately, this dismal picture is further compounded with the emergence of another epidemic plague, HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) in the 80s, as well as the threat of avian and swine influenza infections. This leaves the country with a double burden of health problems – a new epidemic of infectious disease and unresolved infectious conditions, as well as a growing set of non-communicable diseases.
What other pharmacological and social factors could aid the rise of the disease?
Some socio-cultural practices can lead directly or indirectly to the development of chronic kidney disease. These include long-term ingestion of herbal concoctions/preparations, chronic analgesic abuse (certain pain killers) and the use of certain soaps/ creams/lotions used as bleaching agents. Chronic exposure to heavy metals such as lead (found in paints) could also aid the rise of the disease.
At what point does kidney problem become chronic kidney disease (CKD)?
Chronic kidney disease (CKD) is said to occur when there is an evidence of kidney damage based on abnormal urinalysis results (eg, proteinuria, hematuria) or structural abnormalities observed on ultrasound images of the kidneys or a Glomerular Filtration Rate (GFR) of less than 60 mL/min for three or more months.
How can the nation address issue of counterfeit drugs on sale in the market?
The consequences of counterfeit drugs are too grave for the country. The way out of ensuring that counterfeit drugs are done away with in the country lie with us all. First and foremost, the recent activities of the Pharmaceutical Society of Nigeria (PSN) are commendable. Government as well as corporate organisations as part of social responsibilities should, through the media, create continuous awareness amongst the populace on the dangers that such drugs can cause. NAFDAC over time has done a lot in this regard. Finally, corruption is one thing that has to be dealt with firmly and decisively as it relates to counterfeit drugs.
What can government and individuals do to stem the tide of this disease?
This can be achieved through targeted screening of people at risk for kidney diseases, imbibing positive lifestyle modification/behavioural changes as well as ensuring a healthy dietary pattern. Others include avoidance of infections – sexually transmitted infections and urinary tract infection as well as the need to cultivate positive attitude to pre-school and pre-employment screenings and routine medical checkup.
Kidney problems are common, harmful and treatable but now occur in an epidemic manner globally. A huge variety of diseases can affect the function of the kidneys, from acute illnesses to drugs and chronic illnesses. Common causes of Chronic Kidney Diseases (CKD) include inflammatory diseases of the kidney, infections, obstruction in the urinary tract and inherited disorders like polycystic kidney disease. But in both developed and developing nations diabetes and hypertension are becoming the most common causes of CKD. The well-recognised risk factors for CKD include diabetes mellitus, hypertension, family history of kidney disease, cigarette smoking, and abnormal fat in the blood (dyslipidaemia). Others include exposure to heavy metals such as lead, low birth weight (with a reduction in the number of nephrons), and the use of herbal remedies, particularly in Africa. In Nigeria, the commonest causes of chronic kidney diseases are hypertension, glomerulonephritis, diabetes mellitus, and obstructive uropathy.
With the frightening figure released by the association, does it not mean that the nation is losing the battle against kidney disease?
No, the battle is not being lost; rather it calls attention to the gravity of the problem. Government may not be doing enough in respect of addressing the problem of kidney diseases in Nigeria. Non-communicable diseases (which account for the greater majority of the causes of chronic kidney diseases in Nigeria) have become a major health problem, not just in developed countries but also in developing countries. For instance, the prevalence of hypertension in Nigeria is between 15 to 27.7 per cent and studies have shown that blood pressure control rates are poor. It is, therefore, not surprising that hypertension is still the leading cause of CKD in Nigeria. A lot is needed to be done to fight the war against the rising occurrence of CKD.
What does it mean to have kidney failure or kidney-related disease(s)?
The first consequence of undetected Chronic Kidney Disease (CKD) is the risk of developing progressive loss of kidney function leading to kidney failure and the need for dialysis treatment or a kidney transplant. The second is premature death from associated cardiovascular disease. Individuals who appear to be healthy who are then found to have CKD have an increased risk of dying prematurely from CVD (coronary disease, stroke, peripheral artery disease, and heart failure).
Could self-medication be a cause of kidney problem in the country? If yes, how?
Nigerians should refrain from consumption of medications without prescriptions. Certain habit like the chronic use of pain killers, especially the group known as non-steroidal anti-inflammatory agents, is associated with the development of chronic kidney disease.
Can poverty and poor health care system in the country contribute to the rise of the disease in the country?
Health is recognised as an essential component of human development. Many Nigerians still live below the poverty line and do not have good and adequate access to health care. In sub-Saharan Africa, there is a double burden of diseases- infective diseases (such as malaria, gastroenteritis, pneumonia) co-existing with the non-infective diseases, in a resource poor environment characterised by inadequate and moribund healthcare delivery systems. Unfortunately, this dismal picture is further compounded with the emergence of another epidemic plague, HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) in the 80s, as well as the threat of avian and swine influenza infections. This leaves the country with a double burden of health problems – a new epidemic of infectious disease and unresolved infectious conditions, as well as a growing set of non-communicable diseases.
What other pharmacological and social factors could aid the rise of the disease?
Some socio-cultural practices can lead directly or indirectly to the development of chronic kidney disease. These include long-term ingestion of herbal concoctions/preparations, chronic analgesic abuse (certain pain killers) and the use of certain soaps/ creams/lotions used as bleaching agents. Chronic exposure to heavy metals such as lead (found in paints) could also aid the rise of the disease.
At what point does kidney problem become chronic kidney disease (CKD)?
Chronic kidney disease (CKD) is said to occur when there is an evidence of kidney damage based on abnormal urinalysis results (eg, proteinuria, hematuria) or structural abnormalities observed on ultrasound images of the kidneys or a Glomerular Filtration Rate (GFR) of less than 60 mL/min for three or more months.
How can the nation address issue of counterfeit drugs on sale in the market?
The consequences of counterfeit drugs are too grave for the country. The way out of ensuring that counterfeit drugs are done away with in the country lie with us all. First and foremost, the recent activities of the Pharmaceutical Society of Nigeria (PSN) are commendable. Government as well as corporate organisations as part of social responsibilities should, through the media, create continuous awareness amongst the populace on the dangers that such drugs can cause. NAFDAC over time has done a lot in this regard. Finally, corruption is one thing that has to be dealt with firmly and decisively as it relates to counterfeit drugs.
What can government and individuals do to stem the tide of this disease?
This can be achieved through targeted screening of people at risk for kidney diseases, imbibing positive lifestyle modification/behavioural changes as well as ensuring a healthy dietary pattern. Others include avoidance of infections – sexually transmitted infections and urinary tract infection as well as the need to cultivate positive attitude to pre-school and pre-employment screenings and routine medical checkup.
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