“Unfortunately, I can tell you confidently that the number of nephrologists in Nigeria is still less than 250 that cover the entire country.

“By the World Health Organisation’s standard, we should have one nephrologist to 75-100 dialysis or transplant patients.

“If our population is 200 million and we assume that about 10 percent of the population could have kidney disease, that translates to about 20 million and out of this, we assume that the young middle age and the elderly population will cover about 60 percent of our population.

“So, if that translates to about 12 million, it means that we are supposed to have one nephrologist to take care of 100 out of this 12 million.

“So, it means that our number is short of what is supposed to be; we are supposed to have 120,000 nephrologists in Nigeria to take care of patients with kidney disease,” he said.

A nephrologist is a kidney disease specialist who offers the expertise, guidance and support needed for a healthy kidney.

According to Arogundade, nephrologists are located where there are renal care centres and the centres are mainly in the urban centres.

“To increase the number of nephrologists in Nigeria, we need to train more and we need to expose them to what obtains in the best of centres all over the globe.

“This will help to improve the nephrologist-patient ratio, many more patients will have access to good care and many more patient will survive and they wouldn’t die untimely death like we currently see.

“Currently, nephrologists are located where we have renal care centres and these centres are only in the urban centres. So, you may find a lot of nephrologists in Lagos and Ibadan but if you go into the local areas of Oyo State, for instance, you may not find many. Even in Lagos, if you go into areas like Epe or Ikorodu, you may not find many nephrologists in those areas.

“But at least, the distribution in Lagos is better than what we have in other states. If you go up north, you are going to have a lesser number of nephrologists,” he said.

According to the nephrologist, increased awareness is one of the factors influencing the increasing number of kidney cases in the country.

“The conditions that predispose one to kidney disease are high, particularly hypertension and diabetes. The higher these conditions are, the higher the chances that we are going to have an increase in the proportion of people that will eventually develop kidney disease,” he said.

Arogundade noted that the majority of people who develop kidney disease are less than 50 years and usually between 20 and 50 years – which is in sharp contrast to what is seen in developed countries, where those who develop kidney disease are the elderly population, usually about 60 years and above.

He added: “Kidney disease affects virtually every organ of the body.Most times, it affects the heart, the brain, vessels and it could affect the legs.

“If it affects the legs, it could cause heart attack and that is why the commonest death in a patient with kidney disease is the cardiovascular problem.”

Arogundade highlighted that lack of access to treatment and cost of treatment are some of the challenges of nephrology practice in Nigeria.

“Many of the patients can’t afford treatment. The treatment is not available on a large scale in every local government; so those that are not in the urban centres are unable to access treatment.

“Many of the patients die because they cannot afford the treatment, as there is no government subvention for dialysis or transplantation,” he said.

WHO says kidney disease is associated with a tremendous economic burden and high-income countries typically spend more than 2–3 percent of their annual healthcare budget on the treatment of end-stage kidney disease, even though those receiving such treatment represent under 0.03 percent of the total population.

“In 2010, 2.62 million people received dialysis worldwide and the need for dialysis was projected to double by 2030. Globally, the total cost of the treatment of the milder forms of chronic kidney disease appears to be much greater than the total cost of treating end-stage kidney disease. In 2015, in the United States of America, for example, Medicare expenditures on chronic and end-stage kidney disease were more than 64 billion and 34 billion United States dollars, respectively.

“Much of the expenditure, morbidity, and mortality previously attributed to diabetes and hypertension are attributable to kidney disease and its complications,” WHO noted.

source; HealthWise