World Kidney Day raises awareness about renal failure

World Kidney Day, commemorated today (Thursday), highlights the theme ‘Kidney Health for All; Advancing equitable access to care and optimal medication practice’.

End Stage Kidney Failure necessitates treatment options such as dialysis or a kidney transplant, as there is no cure.

Despite offering a better quality of life, kidney transplants require lifelong immune suppressant medication, which can lead to side effects like an increased risk of skin cancer and eventual organ damage.

The average lifespan of a transplanted kidney is approximately 10 years, though some patients have maintained theirs for over two decades.

In South Africa, it is estimated that one in eight individuals is grappling with kidney disease. Regrettably, only one in four patients can afford treatment, and new openings for treatment at state hospitals become available only upon transplantation or patient mortality.

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Although clear guidelines exist for preventing and managing common risk factors like hypertension and diabetes, only a small portion of individuals with these conditions globally are diagnosed, and even fewer receive targeted treatment.

Additionally, many people living with kidney disease are unaware of their condition because early stages are often asymptomatic. Even among diagnosed patients, many do not receive suitable treatment.

Given the severe consequences of kidney disease progression, including kidney failure or death, it is crucial to initiate treatments early and appropriately.

Kidney damage typically progresses gradually, with symptoms often appearing only in advanced stages. You could lose up to 90% of your kidney function without showing signs or symptoms. Risk factors for developing End-Stage Renal Disease (ESRD) are diabetes, high blood pressure and HIV.

Just 40% of individuals with hypertension, and 60% with diabetes are aware of their diagnosis, with even fewer receiving treatment and achieving target goals.

Additionally, at least one in five people with hypertension and one in three people with diabetes also have chronic kidney disease. If you have any of these chronic conditions, you need to have a kidney health screening regularly.

The progression to ESRD can be stopped or slowed down with treatment if diagnosed at an early stage. Renal replacement therapies encompass a kidney transplant, hemodialysis, or peritoneal dialysis.

According to the Mayo Clinic, during peritoneal dialysis, a cleansing fluid called dialysate passes through a catheter tube into part of the abdomen known as the peritoneal cavity.

The dialysate absorbs waste products from blood vessels in the lining of the abdomen, called the peritoneum. Then the fluid is drawn back out of the body and discarded.

This process can be done manually three to four times during the day or for 10 to 12 hours continuously during the night. Hemodialysis involves circulating blood through a machine to eliminate toxins and fluids, typically requiring patients to visit specialised units three times a week for four-hour sessions.

Most dialysis treatments are conducted in the private sector, with a yearly cost of R300 000. Regardless of the patient’s medical aid plan, this expense is covered and paid from the Prescribed Minimum Benefit basket of care.

Kidney transplant recipients experience a reported 10-year increase in overall life expectancy compared to individuals awaiting transplantation. Moreover, there is a notable enhancement in physical functions, mental health, social functioning, and overall perception of quality of life following a successful transplant.

With a 95% graft survival rate after one year, the kidney is the most commonly transplanted organ, boasting the highest success rate.

In South Africa, individuals with the O blood group face a waiting period of 12 to 15 years for a kidney, and tragically, some perish while awaiting transplantation.

The nation contends with a high incidence of kidney diseases and an organ donation rate of less than three per million population, significantly lower than Spain, the world leader in organ transplantation, with a rate surpassing 40 per million population.

While renal replacement therapy is accessible to some in South Africa, delivering these services to those in need poses challenges due to poor living standards, long distances to health facilities, and inadequate compliance and follow-up.

Financial constraints currently impact the functioning of the health sector. However, implementing prevention initiatives, such as monitoring blood pressure and urine dipsticks, can significantly impact early detection and diagnosis of renal disease.

This can lead to appropriate management and a reduction in renal-related diseases requiring renal replacement therapy in the country.