Diabetes, high blood pressure causes of kidney failure

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Alvine Kapitako

Windhoek – Uncontrolled high blood pressure and diabetes are the leading causes of end-stage renal disease in Namibia, according to Tanja Basson of the Windhoek Kidney and Dialysis Centre.

End-stage renal disease – also known as kidney failure – is the last stage of chronic kidney disease. Kidney failure means the kidneys have stopped working well enough for a patient to survive without dialysis or a kidney transplant.

In an interview with New Era, Basson cautioned: “If you know you have high blood pressure and you know you are diabetic you are a target group that’s most likely going to end up with us (dialysis centre). But if you control your high blood pressure and diabetes you don’t necessarily end up with end-stage renal failure.”

Basson explained that people who end up with chronic kidney disease often do not know they have the disease until it is at stage five, because it is “a very silent disease.”

She explained that the first three stages of kidney disease are not easily diagnosed, because patients do not show any symptoms.

“You don’t know that you have kidney failure. It is only in stage four and five that you get symptoms and then start seeking medical help, because you are feeling sick and nauseous and you are [becoming] anaemic,” Basson explained.

She said it is important for people to go for regular check-ups to diagnose the disease early.

“In the first three stages you don’t feel it, you don’t realise that you are sick. Those who are diagnosed early are the people who go for medical check-ups every year,” she said.

She further explained that kidney disease can be prolonged to stage five when the patient would require a transplant or dialysis to survive.

“The doctors can do work with patients who are diagnosed early. These patients would need to be put on a special diet and go for regular check-ups, in addition to their medication to slow it down,” she explained.

Asked whether kidney disease is in the rise, Basson said: “It’s not really on the rise, but we’re now more aware of end-stage renal failure.”

Although there are other causes of kidney failure, such as kidney diseases, some of which are genetic, some patients also injured their kidneys, for example in car accidents.

Minister of Health and Social Services Dr Bernard Haufiku told New Era on Friday that there are at least 300 state patients with chronic kidney disease waiting to be put on dialysis.

There is no state dialysis centre and as a result state patients have to use the private dialysis centres in Windhoek, Ongwediva and Swakopmund.

Haufiku said it is “very expensive” to put state patients on private dialysis, as the State has to pay N$3 000 for each patient.

Basson said there are 200 patients – both state and private – using their dialysis centres. She explained that state patients are sent to their dialysis centre through a special fund in the health ministry.

“They have dialysis machines in the state facilities at [Windhoek] Central Hospital, Rundu and Oshakati to attend to their patients, but they are not many and those machines are usually kept for their acute patients.

“An ICU patient needs dialysis. As a result it is difficult to dialyse chronic patients because the acute patients need it more. So the State does not have the capacity to keep all these chronic patients at their facilities and so they are sent here,” Basson noted.

Meanwhile, Haufiku announced that there are plans to this year set up renal dialysis centres in Windhoek, Rundu and Oshakati. “These would later be followed by Katima, Opuwo and either Swakopmund or Walvis Bay and Keetmanshoop.

Kidney transplant
It is very rare that all patients with end-stage renal failure will get a kidney transplant, said Basson, noting that in Namibia there has to be a willing donor.

“But we do get them. There are four or five patients a year that we can transplant. The only problem is that it takes up to one year to do the preparations for the transplant to take place, she added.

“It’s a lengthy process and some of the patients get demoralised and give up.”

If the transplant is done in South Africa, permission is sought from that country’s health ministry.

This also means that South African doctors have to be involved in the process, Basson added.

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