By Josephine Nwachukwu
At first, it was just fatigue. Then came the persistent headaches, swollen feet, and an unrelenting sense of weakness. By the time Ayodele Fasanya, a 58-year-old lawyer in Lagos, sought medical help, his kidney was already failing.
Diagnosed with end-stage kidney disease, he now requires a ₦17 million transplant to survive. Like Fasanya, thousands of Nigerians wake up to the reality of chronic kidney disease, CKD, every year—many when it is already too late.
Across Africa, kidney disease is a growing public health emergency, claiming lives and leaving thousands in financial distress. In Nigeria, 13.7% of the population is affected, while Ghana reports an even higher prevalence of 28%. In countries like South Africa, Ethiopia, and Kenya, researchers are uncovering alarming trends in the disease’s impact.
Why Black populations are more vulnerable
Black people worldwide suffer disproportionately from kidney failure, a trend deeply rooted in both genetics and environmental factors. In the United States, where Black people make up just 13% to 14% of the population, they account for a staggering one-third of end-stage kidney disease cases requiring dialysis or transplants.
Hypertension, diabetes, and HIV—major causes of kidney failure—are more aggressive in Black populations, leading to rapid deterioration. For years, scientists wondered why until recent research uncovered a significant genetic link.
A groundbreaking study by the Kidney Disease Research Network, involving experts from Nigeria, Ghana, South Africa, Ethiopia, and Kenya, found that a genetic variation known as APOL1 G1 and G2 significantly increases the risk of kidney disease among people of West African descent.
This gene, which originally evolved to protect against sleeping sickness, now comes with a dangerous trade-off: individuals with double APOL1 variants are more likely to develop chronic kidney disease. A study of 8,355 participants in Nigeria and Ghana confirmed this, aligning with findings in African Americans and solidifying the genetic connection to kidney disease.
A costly battle for Nigerian patients
In Nigeria, a diagnosis of kidney disease often feels like a death sentence, not just because of the disease itself but because of the financial burden it brings. Dialysis—the primary treatment for kidney failure—costs up to ₦65,000 per session, a price too steep for many. Without access to affordable treatment, patients face a grim future.
Stories of struggle and survival
Ufuoma McDermott, a popular Nigerian actress, battled chronic kidney disease for 12 years. The delayed diagnosis and prolonged use of painkillers worsened her condition, pushing her to Stage 4 kidney disease before intervention.
Innocent, a Lagos-based evangelist, unknowingly damaged his kidneys through poor dietary habits and unregulated medication use. Unable to afford dialysis on his modest income, his life was saved when his brother, Chigbo, donated a kidney, enabling a successful transplant in India.
Hajara, a young girl from Kano, requires thrice-weekly dialysis sessions costing ₦17,100 each. Financial constraints forced her family to skip treatments, worsening her condition. Her sister, Aisha, offered to donate a kidney, but the ₦5 million transplant cost remains an obstacle.
These experiences reflect the broader challenges faced by CKD patients in Nigeria, including late diagnosis, high treatment costs, and limited access to quality healthcare. Addressing these problems requires a multifaceted approach, encompassing public health education, early screening programs, and healthcare system reforms to make treatments more affordable and accessible.
In contrast, countries like South Africa and Kenya have more structured healthcare systems that provide better access to kidney care. Ethiopia, while still facing affordability issues, has made progress in early detection and intervention.
Nigeria’s urgent need for reform
In 2022, the Managing Director of Rencare Africa, Zahi El-Khatib, raised the alarm that no fewer than 20,000 Nigerians develop end-stage kidney disease annually. Speaking at the launch of the Rencare-RHC Dialysis Centre in Ibadan, he stressed the urgent need for accessible and affordable kidney care.
The new centre, established in collaboration with Redeemer’s Health Centre, aims to provide world-class renal treatment using advanced medical technology. Professor Adeniyi Adenipekun, Chairman of the Redeemer’s Health Centre Board, called for a national focus on kidney disease prevention, early diagnosis, and improved healthcare infrastructure. Without these reforms, Nigeria faces a worsening health crisis.
Breakthroughs Offer Hope
Despite the grim statistics, recent medical advancements are providing hope. Researchers are developing targeted screening programs to identify high-risk individuals early. A new drug, Inaxaplin, is showing promising results in reducing proteinuria—a key marker of kidney disease—by inhibiting APOL1 function. If successful, this treatment could slow disease progression and enhance survival rates.
As Nigeria and other African nations grapple with the rising burden of kidney disease, public health initiatives, government support, and medical research are critical to changing the future. Early detection, affordable treatment, and increased awareness could save millions of lives.
For many patients like Fasanya, Innocent, and Hajara, time is running out. The question remains: Will Nigeria take decisive action before more lives are lost?
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