Kidney Dialysis - Will It Ever Be Affordable to the Ordinary Rwandan - AllAfrica.com Print
By Diane Mushimijimana

Kidney dialysis is life-saving. Without it, patients whose kidneys no longer function well would die relatively quick due to electrolyte abnormalities and the buildup of toxins in the blood stream.

Kidney failure may occur from an acute situation that injures the kidneys or from chronic diseases that gradually cause the kidneys to stop functioning and it is possible to lose 90% of kidney function without experiencing any symptoms or problems, according to medical experts.

Dialysis is an artificial method of filtering the blood and is used when someone's kidneys have failed or are close to failing. Many people with late-stage kidney disease must go on dialysis either permanently or until a donor kidney for transplantation can be found.

Patients may live for several years with dialysis but other underlying and associated illnesses often are the cause of death.

The kidneys have the ability to monitor the amount of body fluid, the concentrations of electrolytes like sodium and potassium, and the acid-base balance of the body. They filter waste products of body metabolism, like urea from protein metabolism and uric acid from DNA breakdown.

"Often, for patients with chronic kidney disease due to diabetes, high blood pressure, or another related medical condition; the patient's medical care team most likely monitors kidney function as part of the patient's routine long-term medical care plan," said Dr Richard Cyamatare, a nephrologist and head of hemo-dialysis department at CHUK hospital.

Dr Cyamatare added that kidney function may return to normal, especially if it is due to an acute obstruction and that obstruction is relieved but severe damage of the kidneys may lead to chronic kidney disease where dialysis intervene as a substitute for many of the normal duties of the kidneys.

Although the statistics are not up-to-date, in Rwanda, Kidney failure is increasing and it is a big burden because the treatment is very expensive that no health insurance service provider can support except RSSB and FARG.

"The cost of dialysis is too high to be afforded by most of the patients and unfortunately there are no kidney transplant services in the country to rely on. For a patient, a dialysis is done thrice a week and each session costs Frw 120,000 and this amount to more than Frw 10 million per month.

"The cost is high and very few patients can afford it. Since September, 2014, we have received a total of 47 patients but because of the high cost of the treatment, many have left to die at their homes," Dr Cyamatare said. Kamariza Herniette , 22, has chronic kidney disease following her symptoms of hypertension. Ensured by FARG, she has been on dialysis at CHUK Hospital since February and will soon go abroad for a kidney transplant after being donated a kidney by her elder sister. She said that her condition has been improving since she was put on dialysis treatment but calls upon government to support other patients who can't afford dialysis. Prevention Dr Cyamatare advises the public to for routine medical tests because the earlier the treatment, the more the chances of healing. He warned people against opting for unprofessional medication, adding that many kidney problems result from wrong medicaments. "Chronic diseases such as hypertension (high blood pressure) and diabetes are devastating because of the damage they can do to kidneys and other organs. Lifelong diligence is important to keep blood sugar and blood pressure within normal limits. Specific treatments depend upon the underlying diseases," Dr Cyamatare said. "Once kidney failure is present, the goal is to prevent further deterioration of renal function. If ignored, the kidneys will progress to complete failure but if underlying illnesses are addressed and treated aggressively, kidney function can be preserved, though not always improved," he added. "Therefore it's important to keep one's weight in check through a healthy diet and regular exercise regimen, as both of these are known to prevent diabetes, heart disease and other conditions associated with chronic kidney disease."

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