Tanzania's burden of kidney disease in focus

Dar es Salaam. The seemingly large increase in the number of patients diagnosed with chronic kidney disease (CKD) in Tanzania could be a product of the increasing awareness, rather than a reflection of the true burden of the disease, experts say.

The president of the Nephrology Society of Tanzania (NESOT), Dr Onesmo Kissanga, says what is currently described as an “increase” in cases of kidney disease may not necessarily be the case.

“People are increasingly turning to hospitals for diagnosis because they are being made aware of the disease…this shows there is need for educating the society, especially about prevention.

“Since many cases of kidney failure have been attributed to high blood pressure, it’s important for people to limit salt intake, do more physical exercises and insist on a healthy diet to protect their hearts and therefore the kidneys,’’ he told The Citizen.

More research needed

Three years ago researchers at the Kilimanajro Clinical Research Institute (KCRI) carried out a study in Northern Tanzania and called for more research in the demographic shift among the people in an effort to prevent CKD.

“…much of the increased urban prevalence [of the disease] remained unexplained…” reads the study in part, published in Plos One Journal, titled “The Epidemiology of Chronic Kidney Disease in Northern Tanzania: A Population-based Survey”. The study pointed out lifestyle practices, including traditional medicine use, socioeconomic factors, and non-communicable diseases (NCDs) as some of the major contributors to the cases of kidney disease in that region.

Cost of treatment high

Currently, over 600 patients are undergoing dialysis treatment due to kidney disease in 17 dialysis centres across the country, according to data from the ministry of Health, Community Development, Gender, Elderly and Children.

“Many of these patients may have ended up with kidney failure because they could not be diagnosed early…mainly due to ignorance about the signs and symptoms of the disease,” says Dr Kissanga.

Recently, high profile government officials teamed up with well-wishers to raise Sh30 million for a Fifth Year medical student at Kilimanjaro Christian Medical Centre (KCMC) College, Mr Arnold Anthony, who is suffering from CKD.

His case, however, is a tip of the iceberg for many patients grappling with CKD that face financial challenges in Tanzania who have to part with over Sh1 million per week to undergo dialysis treatment as they await kidney transplants.

Muhimbili National Hospital (MNH) performed a kidney transplant last year, setting the stage for the procedure to be carried out locally at a cost of Sh21 million, which is lower than the Sh80 million that was being spent by the government on each patient seeking treatment abroad.

This follows the hospital’s first ever successful procedure on a 30-year-old female school teacher on November 21, 2017; in collaboration with experts from BLK Super Specialist Hospital of India.

The country is in the process of drafting a Bill that would guide organ donation and transplant in the future. The country is now operating under the international law and regulations which have been gazetted by the government.

MNH has so far announced plans to carry out kidney transplant surgery on 100 patients or more in the year 2018.

As stakeholders in kidney prevention, there is need to come up with a comprehensive survey on the disease and sustainable strategies for preventing it.