THE UNDER-TREATED

I had the privilege of attending a specialty class in Nephrology Nursing and I am half regretting that move.Don’t get me wrong,I love Nephrology Nursing.What dismays me is the level of ignorance on Kidney failure not only from the healthcare providers but also the general population.

My conscience burns to white ashes when I leave a facility knowing that nothing much will change.Our words as the renal team keep becoming the proverbial water upon a stone.

Maybe because we aren’t drinking the water we preach either.

A study done in Kinshasa showed that Chronic Kidney Disease affected majorly those in the 40-69 year old age group (Handbook of Dialysis;Sumaili et Al 2009).That is not only true but alarming for my country Kenya.

This is so because of inadequacies in data and a lot of hollow holes in the reporting systems.The age group this mentioned is ripe at production.This is when life truly begins and the output is greatly enhanced.

When we therefore tie ourselves to renal replacement therapies,we all end up losing as a country.That is because that time is better utilised elsewhere.This is why prevention and sufficient treatment of kidney disease is Paramount.

Urine dipstick is the oldest,cheapest mode of detecting anomalies in urine.#TeamPhoenix,please remember we need to examine the urine to know what’s happening with your kidneys.Please tell me you remember this relationship from our earlier conversations…

I however put it to you healthcare providers that it will be even better for you to do a quick albuminuria dipstick.

#TeamPhoenix wangu,this is just an improved form of disptick that is able to detect a certain protein called ‘Albumin’ in your urine.Wait eti what dipstick is?

Alright, anyone who’s attended antenatal clinic here? Anyone? Saaaasa,there is this point the Nurse sends you to the lab for urine exam,sio?Or the Nurse gives you a container to bring your urine sample in,then s/he inserts a kasomething that looks like a stick then reads it to you,right?

Now that’s what a urine dipstick is.Sawa?Men,maybe you’ve also seen it done at the laboratory on your urine sample.Shall I continue now?Hehe asanteni 🤭

Microalbuminuria is one of the commonest flags that will tell you that indeed,there is a problem with the kidneys.Medics,stop ignoring results because they don’t conform to your preferred diagnosis.

In the US,a study shows that the prevalence of Chronic Kidney tis 4.2fold higher in Afro-Americans as compared to Whites.The same study discovered that people in less advantaged socio-economic groups are even more afflicted by kidney disease and receive late to no referrals to the Nephrologist (Handbook of Dialysis pg 210-211).

Look,if you have a patient under your care that has any of the initiating factors of renal failure like Hypertension or Diabetes Mellitus type 2,please refer them to a Nephrologist for screening.This does not require any sophistication.Just awareness.You to be aware and the client to be aware.

It is hard enough to be under tough economic times.Let us not compound that by unnecessarily condemning a patient to dialysis and its associated sequelae and financial burden by failing to arrest progression of kidney disease early.

To the specialists pale Doctor’s plaza,it doesn’t mean you’re incapable of handling your patient and that’s why you referred them.No,it means you care very much about their general health and that’s why you’ve sent them to a Nephrologist.

#TeamPhoenix,if you have a relative suffering from Diabetes Mellitus type 2 and/or Hypertension,please suggest to their doctor about a screening for Kidney function every 3 months.

Am I speaking to someone?KIDNEY FUNCTION EVERY THREE MONTHS.Was that loud enough?😭

Our Mums, Dads,bros,sis, auntie etcetera suffering Diabetes or Hypertension, Catherine is saying,KIDNEY FUNCTION TESTS EVERY THREE MONTHS.I should stop the capitalization,right?Ha ha.

I believe if we all did better screening and early referrals,we would greatly reduce the number of patients entering the Dialysis register on a daily basis.

I know we are in a position to collectively attack Chronic Kidney Disease from all avenues.We can do more.We can sufficiently pay attention to this global killer.

Please remember that this disease overburdens those least able to cope ( Agodta et Al 2005).Ask any Renal nurse working in a public renal unit the general wage of the clients under our care.

Have you seen the financial mess Kidney disease has left many a families in?Aki watu…yo’d understand why I’m advocating for doing our best as our very best against kidney disease.Kidney transportation cost itself run into the millions!Who has that kind of money? Even if they did,isn’t it better put to more productive use like education?

Am I the only one feeling the pain my patients go through?

I know you’ll tell me the National Hospital Insurance Fund caters for dialysis.However,does it cater for it really?

Patients must undergo some blood tests every month and others every three months whose cost NHIF does not meet.

That plus the strict dietary restriction (read expensive foods) required by renal patients to avoid toxicity in their blood.

Those ,NHIF does not cover.How will you then convince me that Renal Replacement Therapy is catered for by NHIF?

Dialysis isn’t just about hooking a patient onto a machine and unhooking them.We need to achieve adequate clearance of toxins from the blood.We will never know if we actually achieve that if we don’t run many,almost serial,blood tests.

Let us all play our part in prevention.Myself here,I will keep enlightening our clientele.

Till next time,thank you people.

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