When your kidney ails

Kidney transplant

It has been said that our kidneys work as a very complex, environmentally friendly, waste disposal system that sorts out non-recyclable waste from recyclable waste 24 hours a day.

These fist sized organs also clean your blood and they processes about 200 litres of blood every single day. Once they are done with their duty, kidneys then make urine from the body’s excess fluid and unwanted chemicals or waste found in the blood.

Because of the vital role they play in our bodies, having healthy kidneys is key to our general health and well being. There are, however, instances when a transplant is needed, after disease sets in, and this is often a medical emergency requiring urgent attention.

According to Dr Ahmed Sokwala, Consultant Physician and Nephrologist at Aga Khan University Hospital, a transplant will be recommended when a patient has chronic kidney disease (CKD) or kidney failure — which means the organs are unable to remove waste and excess water from the bloodstream.

“As waste and fluids accumulate, other body systems get affected which leads to complications. It is a dreaded disease and is increasing at an alarming rate all over the world. In fact, one in ten persons has some form of chronic kidney disease and about four million Kenyans have a form of kidney disease,” he said.

While various illnesses can cause permanent damage to the kidneys, the two main causes of this disease are diabetes and high blood pressure which account for about two thirds of the damage. Obesity, smoking and high cholesterol levels are also contributing factors.

According to Dr Ahmed, diagnosis of the disease can be done through a urine test, which looks for protein in the urine or through a biopsy.

“A small piece of kidney tissue is removed and examined under a microscope in order to identify abnormalities in kidney tissue that may be the cause of the disease,” he said.

When caught early the disease is treatable but in many instances, patients do not seek medical aid until it is too late or they are misdiagnosed. When this happens, the disease moves to an advanced stage at which point dialysis and transplant becomes the only option.

“There is no remedy for advanced CKD. The only solution is dialysis - a procedure by which waste products and excess water that accumulates in renal failure are removed from the body using machines - or a kidney transplant,” he said.

The doctor says at advanced levels, the best treatment is to surgically replace the sick kidney with a healthy one. This procedure is available locally and is even covered by the National Hospital Insurance Fund.

“Successful kidney transplant offers better quality of and longer life. Also, the patient’s chances of survival are higher when compared to dialysis,” he said.

Although there is no fixed criteria for the age of a kidney transplant recipient, it is usually recommended for persons from five to 65 years of age.

There are three sources of kidneys for transplantation: Living donors who are blood relatives of the patient, deceased donors who are people who have died from brain death and and any healthy person willing to donate one kidney so long as the blood group, tissue type and cross-matching are compatible with the patient.

“Generally, donors should be between the ages of 18 and 65 years and the recipient and donor must have either the same blood group, or compatible groups. In blood transfusions, a donor with blood group O is considered a ‘universal’ donor,” Dr Ahmed said.