About 25.4 million adult Nigerians may be living with overt or covert chronic kidney disease (CKD), Vice Chancellor of the University of Medicine and Medical Sciences, Abeokuta, Professor Fatiu Arogundade, has said.
Arogundade disclosed this while delivering the 430th Inaugural Lecture of Obafemi Awolowo University (OAU), Ile-Ife, Osun State, titled: “The Burden, Barriers, Bottlenecks and Breakthroughs in the Management of Kidney Disease in Nigeria: A Journey from the Grassroots to the Frontiers.”
Drawing on more than three decades of clinical practice and research, the professor described kidney disease as an epidemic and a major public health challenge, warning that Nigeria urgently needs a coordinated national response covering prevention, early detection and affordable treatment.
He said Nigeria still lacked a single national registry for determining the definitive prevalence of CKD, adding that a review of peer-reviewed Nigerian studies involving 14,250 participants produced a pooled prevalence of 20.4 per cent.
According to him, applying the figure to the adult population suggested that about 25.4 million Nigerians could be living with overt or covert CKD, while approximately 127,000 could have advanced CKD or end-stage renal disease.
Arogundade said CKD in Nigeria had a distinctive demographic pattern, affecting many people between 20 and 50 years of age, unlike in developed countries where the disease is more commonly associated with older populations.
He identified hypertension and glomerulonephritis as the leading causes, with diabetes, HIV-associated nephropathy and obstructive kidney disease also contributing significantly.
The don said environmental exposures and sickle cell disease were also important contributors to the burden of kidney disease in Nigeria.
According to him, research by his team found that people with high hydrocarbon exposure had more than four times the risk of developing glomerulonephritis-associated CKD, while CKD was found in about 35 per cent of sickle cell patients.
He identified age, worsening anaemia, and frequent and severe vaso-occlusive crises among the important predictors of CKD in sickle cell patients.
Arogundade identified the high cost of kidney replacement therapy as one of the biggest barriers to care, saying inadequate health insurance coverage leaves most Nigerian patients heavily dependent on out-of-pocket payments for dialysis.
He said this exposes families to catastrophic expenditure and contributes to treatment abandonment and premature deaths.
Although kidney-care centres have increased from fewer than five in the 1980s to more than 100, Arogundade said they remained inadequate and were concentrated largely in urban areas.
He therefore called for government subsidisation of dialysis and kidney transplantation, as well as expanded health insurance coverage, to improve access to care.
Arogundade advocated greater use of peritoneal dialysis, particularly through the local production of dialysis fluids, saying this could reduce treatment costs and expand access.
He said research from OAU had demonstrated the feasibility of continuous ambulatory peritoneal dialysis using locally sourced materials.
He therefore recommended that peritoneal dialysis be incorporated into Nigeria’s national kidney-care strategy.
The professor, however, expressed concern over reports of organ trafficking and called for stronger regulation of transplantation and organ donation.
Arogundade identified the migration of trained health professionals as another major bottleneck to kidney care and called for better remuneration, improved working conditions, enhanced security and adequate social amenities to retain skilled professionals.
The Vice Chancellor called for a national kidney-care policy to coordinate prevention, screening, treatment, research and training.
He advocated routine screening for kidney disease among children undergoing school admission medical assessments, adults at their first contact with healthcare facilities and other high-risk groups.
He also urged Nigerians to reduce salt consumption, avoid smoking and excessive alcohol use, prevent obesity, and avoid the indiscriminate use of analgesics and other potentially nephrotoxic substances.
He called for increased government funding for kidney research and proposed the establishment of a National Kidney Foundation or similar dedicated funding mechanism to address Nigeria’s specific gaps in kidney prevention, treatment and training, while strengthening the country’s contribution to global nephrology.
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