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Kidney disease surges against limited facilities

UNIVERSITY Teaching Hospital’s department of surgery renal transplant surgeon Michael Mbambiko (left) with kidney unit nephrologist Charles Mutemba in Livingstone recently.

CHIMWEMWE MWALE, Livingstone
THEY are said to be the unsung ‘workhorses’ that never get noticed until something goes wrong with them. Kidneys filter an approximated 200 litres of blood a day, help regulate blood pressure and direct red blood cell production in the body.
Kidneys are, however, also prone to disease and one can be at risk for kidney disease due to diabetes, high blood pressure, or a family history of kidney failure according to medical experts.
Some of the symptoms of kidney disease include tiredness, decreased appetite, difficulty in concentrating and/or sleeping, swollen feet and ankles.
Other symptoms include puffiness around the eyes, muscle cramping especially at night, dry itchy skin, more frequent urination and blood or bubbles in urine.
Also referred to as a silent epidemic, kidney disease is on the rise in Zambia prompting medical practitioners to get to the proverbial drawing board.
“The volume of patients is increasing, without having an exit and exit to kidney disease is only when we have transplants. We can only reduce the volume by transplants. We have demonstrated to Government that it is very expensive if patients are continuously on dialysis but it’s cheaper to manage patients after transplanting.
“We have only transplanted a few patients outside the country in India especially, and so far, we have been tasked to start the initial transplant in the country,” says University Teaching Hospital (UTH) kidney unit nephrologist Charles Mutemba.
Dr Mutemba said UTH in 2016 and 2017 recorded 8,000 and 12,000 patients respectively at the dialysis unit indicating a significant increase in the number of patients with kidney disease.
He said in an interview that there is also need to expand the existing dialysis services in Livingstone, Ndola, Kasama, Chipata, and Solwezi.
Dr Mutemba said it is challenging for patients from outside Lusaka to get dialysis services as they are supposed to access the facility three times a week to sustain their life.
“So, if someone lives and works outside Lusaka, you can understand the challenges they face. This is why we are saying no one can be on dialysis for life, and this why we are intensifying efforts for [kidney] transplants,” Dr Mutemba said.
UTH is this year expected to carry out its first kidney transplant in the country.
Dr Mutemba said this is because it is costing Government colossal amounts of money for the procedure to be done abroad.
Currently, most patients with kidney disease requiring organ transplant receive medical attention in India.
And UTH department of surgery renal transplant surgeon Michael Mbambiko said the medical team is working on a programme to inform people about the benefits of kidney transplant and addressing concerns about the procedure.
Dr Mbambiko said the transplant programme will involve obtaining kidneys from live donors.
He said this is becausee it is a much easier system to start the procedure as compared to using the cadaveric procedure which involves obtaining kidneys from a dead person and requires a lot of resources.
A cadaveric kidney comes from a dead donor.
He said kidney transplantation is a complex procedure and requires a multi-disciplinary team and equipment to undertake.
Dr Mbambiko said in an interview that UTH is working with a number of partners to undertake the exercise.
“We are happy that government is giving us a lot of support and we are hopeful that sometime this year, we will do our first transplant. I am unable to state the date but we are working with various partners and we are looking forward to our first transplant and see how it works,” he said.
Meanwhile Livingstone Central Hospital medical superintendent John Kachimba says there is need for medical practitioners in the country to help find solutions in the decentralisation of renal services.
Dr Kachimba said this will help Government to significantly reduce the cost of the services.
He said a holistic approach should be developed to help patients suffering from kidney disease to access medical attention.
Dr Kachimba said the responsibility of improving renal care is for all medical practitioners and stakeholders and not just Government.
He said this in Livingstone recently during the official opening of the first ever renal symposium programme which attracted several medical practitioners from around the country.
The symposium, which was being hosted by CK Scientific Group Zambia Limited, in partnership with Braun, was dubbed: “Embracing industry, development and innovation in renal services in Zambia.”
“We all need to work together to deliver quality health care and bring about public awareness on kidney disease,” Dr Kachimba said.
He said efforts are being made by Government to make renal services available across the country as part of the reforms in the health sector.
However, the services are expensive and some patients cannot afford them, hence the need to make them more accessible and available, Dr Kachimba said.
“Even the clients we are dealing with now are a tip of an iceberg. Most of the clients don’t even make it to access our services,” he said.
Dr Kachimba commended CK Scientific Group Zambia Limited for its efforts and provision of equipment for renal services in the country.
It is hoped that Zambia’s swelling kidney disease burden will subside, especially with the planned intervention of transplant within the country.

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