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Wanted: Kidney specialists in Kenya

NAIROBI, July 18 – Kenya is suffering from a serious shortage of nephrologists (kidney specialists) with only 15 practicing kidney physicians countrywide.

The Kenya Renal Association Friday said the limited manpower was unable to cope with the 80,000 patients who suffer kidney (Renal) related complications in the country.

During the launch of guidelines for vaccination of chronic kidney patients, association member Professor Mohammed Abdullah said 15,000 people in the country lose their kidneys annually due to late diagnosis.

“Kidney diseases are a silent killer,” he said and urged the government to provide early detection tools in hospitals.

“We can actually make it routine for all the district hospitals, no matter the reason for a patient’s admission, to use a little drop of urine from a patient, put a dipstick and see whether they are spilling proteins. This way, we can sift out, very quickly, those patients who already have problems with their kidneys. We can actually prevent large numbers of unnecessary deaths,” Professor Abdullah stated.

Medical Services Minister, Anyang’ Nyong’o noted that there were only 24 dialysis machines at the country’s largest referral institution- the Kenyatta National hospital (KNH).

“This is the highest concentration of dialysis machines in this country and this is a cause of concern because if the rate of increase is at six percent annually, and the services that we have are low, it is very tragic,” Nyong’o asserted.

People suffering from Kidney problems are classified in five stages;

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The first state refers to those suffer some infection in their kidney but it operates within normal limitations. At stage two, one loses about 10 percent of the kidney functions while one may lose up to 40 percent of kidney functions at stage three.

At stage four, 70 percent of kidney functions are lost, which means they are progressing towards the End Stage Renal Disease (ESRD) necessitating long- term dialysis or kidney transplant to sustain life.

“You will find people suffering from kidney problems walking around looking normal not sensing that they are in trouble. Very often such people have non- specific symptoms like early tiredness but they continue struggling and putting in more effort,” says Professor Abdullah.

He cautions that those patients progressing towards the end stage should be careful not to contract any viral illness which could shorten their lifespan.

It is estimated that incidences of chronic kidney diseases worldwide are currently at an annual rate of six percent annually which is much higher than the rate of population growth, estimated at 1.2 percent annually.

Nyong’o noted that Diabetes mellitus, hypertension and Glomerulonephritis were the three commonest causes of End Stage Renal Disease hence their control was important in primary medical care practice.

Currently, there are only two government facilities- Kenyatta National Hospital and the Eldoret-based Moi Teaching and Referral Hospital offering dialysis services for kidney patients.

Meanwhile, Nyong’o said the government would consider implementing a health worker vaccination policy that advocated for inoculation of all health care workers as a way of promoting occupational safety.

He said this was due to the risk that health workers were exposed to in the line of duty.

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“Giving risk allowance is no substitute for making sure that we protect ourselves from the risk. So the two must be done concurrently- recognize that they are at risk as they work and therefore give them a compensation for that in terms of material gain but also ensure that we do not expose them unnecessarily to the risk,” he stated.

At the same time, Professor Abdullah, noted that health workers were largely exposed to direct blood from patients hence the need for protection.

“All of them, as a policy, should be vaccinated for those health workers who are exposed to large amounts of blood either by surgery, delivery, or by handling it in laboratories and those in the renal world,” he said.

Nyong’o however cried foul over what he said were plans to transfer some of his ministry’s functions to the Ministry of Public Health and sanitation, headed by Beth Mugo.

He said there was a proposal in the government to reassign dispensaries and health centres to the Ministry of Public Health and sanitation.

“It doesn’t make sense to me at all because if you are going to make sure that detection of diseases is done from primary level then you have those institutions in a different ministry, you are obviously creating a bureaucracy that will make us go two steps backwards and one step forward.”

“I have spoken up against it but there is a system called government that quite often doesn’t listen rationally.” 

Presently, the Ministry of Medical Services is in charge of all health facilities and curative services while the Ministry of Public Health is in charge of preventive health and sanitation services.

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