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August 19, 2018

Ochiedike And IMSU: The Unfolding Humanitarian Crisis For Kidney Patients

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There are primarily two facilities that offer diagnosis and treatment for Kidney related problems owned by the Imo state government. One is the Imo state teaching hospital at Orlu and the other, the Ochie Dike Centre at Owerri. I am not aware of any such similar facility in Okigwe but there should be  one sooner than later  given the extreme fatigue faced by Kidney patients in long distant exertions or mere walking: The state has to build expansive institutions of compassion in the relentless match of progress in the spirit of parity.

The Ochie Dike dialysis centre established by the Imo state government under the present administration of Owelle Rochas Okorocha was Timely. Prior to that, Kidney patients faced harrowing times, poor service delivery and exploitation elsewhere . Ochie Dike    addressed the issue of the growing numbers of Imolites with kidney challenges who depend on regular dialysis for the sustenance of a productive existence and lifestyles. Haemodialysis is itself the processes of removing waste products from the blood in the event of kidney failure and Ochie Dike represented that noble vision.

The kidney is itself an organ that filters the blood producing urine. In any event, the urine is itself excrement consisting of water salt and urea which is made in the kidney and stored in the bladder and then released through the urethra.

When a person has Kidney challenges, it means that the ability of the kidney to perform its functions has become impaired. A normal human body has two kidneys but the functions of the kidney can be performed by a single healthy kidney.

The solution to kidney challenges depend on the extent of scar, damage or failure but the application of dialysis is more like the treatment of the symptoms rather than the provision of a relative cure. In the end, a patient may require kidney transplant; the final frontier.

Indeed the ultimate solution lies in the provision of kidney transplant from a suitable donor which will enable the recipient to live a normal life with continued chemotherapy which remains a lifelong possibility. The legal framework for accessing kidneys by beneficiaries, remains fraught with uncertainties as these human organs are coming at a great price for sufferers. A lot of potential donors are going to their graves with useful human organs needed by patients because of the unexplored legal and humane frameworks which are hardly canvassed or duly appreciated in Nigeria.

However, in setting up the Ochie Dike Dialysis centre, the government seemly has ignored the immense opportunity of making the centre a facility for research, treatment and transplant of kidneys by the provision of international benchmarks, high standards of medical practices with adequate medical personnel and facilities. For instance in the simple process of dialysis, the Ochie Dike,  employs manual procedures which are painful exposing the patient to greater risks rather than canalization which allows for efficiency and ready flow.

Background Study:

There are many reasons accounting for kidney failure according to our sources from medicine .com, an online medical journal. But first we must appreciate the import of kidney functions and the causes and consequences of its failure in order to fully appreciate the implications and possible complications of kidney failure to the individual:

The role of kidney:

The kidneys play key roles in body function, not only by filtering the blood and getting rid of waste products, but also by balancing the electrolyte levels in the body, controlling blood pressure, and stimulating the production of red blood cells

The location of the Kidney in the body:

The kidneys are located in the abdomen toward the back, normally one on each side of the spine. They get their blood supply through the renal arteries directly from the aorta and send blood back to the heart via the renal veins to the vena cava. (The term “renal” is derived from the Latin name for kidney.)

The functions of the Kidney:

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. Two waste products in the blood usually are measured; 1) blood urea nitrogen When blood flows to the kidney, sensors within specialized kidney cells regulate how much water to excrete as urine, along with what concentration of electrolytes. For example, if a person is dehydrated from exercise  or from an illness, the kidneys will hold onto as much water as possible and the urine becomes very concentrated. When adequate water is present in the body, the urine is much more dilute, and the urine becomes clear. This system is controlled by renin, a hormone produced in the kidney that is part of the fluid and blood pressure regulation systems of the body.

Kidneys are also the source of erythropoietin in the body, a hormone that stimulates the bone marrow to make red blood cells. Special cells in the kidney monitor the oxygen concentration in blood. If oxygen levels fall, erythropoietin levels rise and the body starts to manufacture more red blood cells.

Urine that is made by each kidney flows through the ureter, a tube that connects the kidney to the bladder. Urine is stored within the bladder, and when urination occurs, the bladder empties urine through a tube called the urethra.

What is kidney failure?

Kidney failure may occur from an acute situation that injures the kidneys from chronic diseases that gradually cause the kidneys to stop functioning. In acute renal failure, kidney function is lost rapidly and can occur from a variety of insults to the body. Since most people have two kidneys, both kidneys must be damaged for complete kidney failure to occur. Fortunately, if only one kidney fails or is diseased it can be removed, and the remaining kidney may continue to have normal kidney (renal) function. If  both patient’s kidneys are injured or diseased, a donor kidney(s) may transplanted.

The list of causes of kidney failure is often categorized based on where the injury has occurred.

Prerenal causes (pre=before + renal=kidney) causes are due to decreased blood supply to the kidney. Examples of prerenal causes of kidney failure are:

Hypovolemia (low blood volume) due to blood loss

Dehydration from loss of body fluid (eg from vomiting, fever

Poor intake of fluids

Medication, for example, diuretics (“water pills”) may cause excessive water loss

Abnormal blood flow to and from the kidney due to obstruction of the renal artery or vein.

Renal causes of kidney failure (damage directly to the kidney itself) include:

Sepsis: The body immune system is overwhelmed from infection and causes inflammation and shutdown of the kidneys. This usually does not occur with simple urinary tract infection.

To be contd.



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