Surge in kidney disease in Nigeria has experts stumped | DW News

Chronic Kidney Disease Surge in Northeastern Nigeria: A Detailed Summary

Key Concepts:

• Chronic Kidney Disease (CKD)
• Prevalence Rate
• Dialysis
• Kidney Transplant
• Over-the-counter (OTC) Pharmaceuticals
• Dehydration
• Environmental Factors (Heat)
• Genetics
• Riverine Areas
• Heavy/Trace Elements in Water
• Lifestyle Factors
• Traditional Herbs
• Nephrons

1. The Alarming Rise of Chronic Kidney Disease

• Northeastern Nigeria, specifically Borno and Yobe states, is experiencing a surge in chronic kidney disease (CKD) cases.
• The number of patients requiring dialysis and kidney transplants is unusually high, raising concerns among health officials.
• The cause of this surge remains largely unknown, prompting investigations.

2. Patient Experiences and the Dialysis Process

• The nephrology ward at the University of Maiduguri Teaching Hospital is overwhelmed with patients.
• Abdullahi, a dialysis patient, undergoes hemodialysis twice a week, with each session lasting approximately 4 hours.
• The dialysis procedure involves removing blood, filtering out toxins and excess fluids, and returning the cleaned blood to the body.
• Dialysis is described as a temporary solution, with kidney transplant being the preferred long-term option.
• The financial burden of dialysis is significant, with each session costing Abdullahi almost 40,000 (currency not specified), forcing him to sell belongings to afford treatment.

3. Prevalence Rates and Hotspots

• Global prevalence of kidney disease is between 12% and 14%.
• In Borno state, the prevalence is almost twice the global average.
• Guang, a community within the Maiduguri metropolis, has the highest prevalence, with approximately 3 in 10 people likely to have CKD.
• Overall prevalence in Maiduguri metropolis is about 26%.
• A study conducted last year showed the prevalence of kidney disease in Nigeria to be about 18% to 20%.

4. Investigating the Causes: The Ongoing Study

• Authorities have commissioned a study to determine the factors driving the high prevalence of CKD.
• Factors under consideration include:
  • Use of unregulated over-the-counter (OTC) pharmaceuticals, particularly painkillers.
  • Contamination of drinking water with specific compounds and minerals.
  • Increased use of insecticides on grains and fresh produce.
  • Genetic predisposition.
• Preliminary data suggests a link between dehydration and the hot environment.

5. The Role of Environmental Factors: Heat and Dehydration

• The region experiences extremely high temperatures, reaching 42-44°C during summer.
• High temperatures lead to excessive perspiration and dehydration, which can injure the kidneys over time.
• Individuals may not be consuming enough fluids to compensate for fluid loss through perspiration.
• Rising temperatures due to climate change are exacerbating the problem.
• Dr. Umate mentions that the high temperatures seem to increase the prevalence of kidney disease because people don't pass a lot of fluids, causing the nephrons to die gradually.

6. Dr. Umate's Insights: Water, Lifestyle, and Genetics

• Dr. Ibrahim Umate, Director of the Kidney Center at the University of Maiduguri Teaching Hospital, provides insights into the potential causes.
• For Yobe state, the source of water, particularly in riverine areas around the River Yobe, is suspected due to the presence of heavy or trace elements.
• Water studies in Borno state have not implicated water quality as a primary cause.
• Lifestyle factors in Borno are considered significant, including:
  • Overuse of OTC medications, especially painkillers, without consulting healthcare professionals.
  • Consumption of traditional herbs.
• Genetic factors are now being investigated to determine if there is a genetic predisposition to kidney disease in the region.
• Dr. Umate emphasizes that the issue of drugs and herbs is that people take them in overdose, without knowing the correct dosage.

7. Government Initiatives

• The local government in Borno state is increasing its capacity to provide affordable healthcare for people with kidney disease.
• This includes subsidizing the cost of kidney transplants.

8. Next Steps: Intensive Campaign and Enlightenment

• Once the study findings are complete, an intensive campaign and enlightenment program will be launched to reduce the prevalence of kidney disease.

9. Conclusion

The surge in chronic kidney disease in northeastern Nigeria is a complex issue with multiple potential contributing factors. While environmental factors like heat and dehydration play a role, lifestyle choices, potential water contamination in specific areas, and genetic predispositions are also under investigation. The ongoing study aims to provide a comprehensive understanding of the causes, enabling targeted interventions and public health initiatives to address this critical health challenge.