Recent report by World Health Organisation (WHO) shows that presently 36.8 million Nigerians (23 per cent of the total population) are suffering from different forms of kidney disorder while an estimated 15,000 new patients are diagnosed every year. In this interview with Consultant Nephrologist/Transplant Physician with the University of Lagos Teaching Hospital (LUTH), Dr. (Mrs.) Toyin Amira, she reveals how important the kidneys are, steps to take in caring for your kidney and what you must know before giving away your kidney, Omolara Akintoye writes
THERE was the story of a man who recently came back from Malaysia after six months and before you knew what was happening he had bought properties, car and started living large. All of a sudden, he fell sick and, eventually, got diagnosed with failed kidney. He later admitted that he travelled to Malaysia to sell his kidney for 50million naira but it appeared they played a fast one on him; they removed both kidneys and replaced one with a weak kidney. So many young Nigerians are now selling their kidneys, most especially yahoo boys, and that rumours of kidnapping cases among Nigerians living in Malaysia isn’t about rituals, it is actually about ‘KIDNEYS’. Data shows that Malaysia has the highest number of kidney-related diseases in the world Are there any short term effects from donating a kidney? There are potential medical complications following donation. For instance, studies have shown that blood pressure can rise a bit after the donation process. There are more worrisome long-term medical complications, including the need for dialysis in the future. We hope to minimise this through our evaluation process, but we know there will be some donors who, unfortunately, do lose their kidney function and require dialysis. Several recent studies, however, have shown that donors tend to do as well or better than the general population in regard to long-term medical complications. If someone donates a kidney and later in life that kidney fails, do they receive priority for a transplant themselves? Unfortunately, some donors have lost their kidney function and require dialysis several years after donation. There is a priority system in place so that donors receive extra points for deceased donor kidney transplant when they are on the waiting list. After donation, what is the recovery period and when can the donor return to normal activities? The length of stay in the hospital will vary depending on the individual donor’s rate of recovery and the type of procedure performed (traditional vs. laparoscopic kidney removal) although the usual stay is four to six days. Since the rate of recovery varies greatly among individuals, be sure to ask the transplant centre for their estimate of your particular recovery time. After leaving the hospital, the donor will typically feel tenderness, itching and some pain as the incision continues to heal. Generally, heavy lifting is not recommended for about six weeks following surgery. It is also recommended that donors avoid contact sports where the remaining kidney could be injured. It is important for the donor to speak with the transplant staff about the best ways to return as quickly as possible to being physically fit. How does living donation affect the donor? People can live normal lives with only one kidney. As long as the donor is evaluated thoroughly and cleared for donation, he or she can lead a normal life after the surgery. When the kidney is removed, the single normal kidney will increase in size to compensate for the loss of the donated kidney. Donors are encouraged to have good long-term medical follow-up with their primary care doctors. A urine test, a blood pressure check and a blood test for kidney function should be done every year. What are the long-term risks of donation? You will also have a scar from the donor operation – the size and location of the scar will depend on the type of operation you have. Some donors have reported long-term problems with pain, nerve damage, hernia or intestinal obstruction. These risks seem to be rare, but there are currently no national statistics on the frequency of these problems. In addition, people with one kidney may be at a greater risk of: High blood pressure Proteinuria Reduced kidney function You should discuss these risks with your transplant team, and ask for centre-specific statistics related to these problems. Are there any dietary restrictions after donation? After donation, you should be able to go back to a regular, healthy lifestyle. If you are in good health, there will probably not be any specific dietary restrictions. Talk with your transplant team about your specific dietary needs. What if I donate, and need a kidney later? This is something potential donors should discuss with the transplant team. Talk to your transplant team about any pre-existing condition or other factors that may put you at a higher risk of developing kidney disease, and consider this carefully before making a decision about donation. Can I become pregnant after I’ve donated kidney? Pregnancy after donation is possible but is usually not recommended for at least six months after the donation surgery. Living donors should talk to their ob/gyn and transplant team before getting pregnant about pregnancy and make sure that they have good pre-natal care. Generally, living kidney donors do well with pregnancy after their donation. However, some studies have shown small increases in some risks like gestational diabetes, pregnancy-induced hypertension, protein in the urine and pre-eclampsia. Living donors should inform their ob/gyn about their donation to allow monitoring for these potential complications. Living with one kidney Most people live normal, healthy lives with one kidney. However, it’s important to stay as healthy as possible, and protect the only kidney you have. Can one transplanted kidney work as well as two? Yes. Testing has shown that a transplanted kidney can also increase in size and function. Are there any long-term problems for people with a single kidney? In general, most people with a single, healthy kidney have few problems. However, some long-term problems have been seen in some people. In some people who were born with a single kidney, or had a kidney removed during childhood, there is a chance of some slight loss in kidney function later in life. This usually takes 25 years or more to happen. There may also be a chance of having high blood pressure later in life. However, the loss in kidney function is usually very mild, and life span is normal. Most people with one kidney live healthy, normal lives with few problems. How often should someone with one kidney see a doctor? You should have your kidney function checked at least once a year. Your healthcare provider will check your kidney function by giving you a simple urine test and a simple blood test. You should also have your blood pressure checked every year. Can a person with one kidney participate in sports? Physical exercise is healthy and good for you. However, it’s important for someone with only one kidney to be careful and protect it from injury. This recommendation applies to anyone with a single kidney, including people who were born with one kidney and people with a kidney transplant. Some doctors think it is best to avoid contact sports like football, boxing, hockey, soccer, martial arts, or wrestling. Final word Beyond commercial kidney transplantation, there is the need for the three tires of government to improve its health care system and health insurance for the scheme to handle cases such as these. There are many countries which are not as rich as Nigeria, but their health care system is better than what we have in Nigeria because the ruling class and those who are responsible for health issues have actually taken the right decisions to enable people benefit from quality health care system.