World Kidney Day falls on 8th March 2018, and as the years go by we are faced with an alarming increase in chronic kidney disease. The theme for this year’s commemoration is Kidneys and Women’s Health.
The Ghana Police Hospital Dialysis Center commemorates this day at an event at the forecourt of the hospital under the auspices of the Vice President of the Republic of Ghana Alhaji Dr Mahamudu Bawumia.
Across the globe, 10 percent of the population is affected by preventable yet deadly kidney diseases. Chronic Kidney Disease was ranked 18th in the list of causes of total number of deaths worldwide according to the 2010 Global Burden of Disease study. The degree of movement up the list was second only to that for HIV and AIDS.
DIALYSIS HISTORY IN GHANA:
In Ghana, kidney failure forms about 35-40% of all medical admissions at hospitals, most patients with ages between 25-45 years. For every 10 admissions to a hospital emergency ward, 4 admissions have kidney related conditions. Unfortunately, also, a significant portion of patients diagnosed with kidney disease in Ghana are in their productive ages whereas the situation is the reverse for advanced countries.
Due to expensive treatment costs and poor coverage of national dialysis centers, less than 20% of these patients received haemodialysis treatment. The rest manage conservatively and some end up losing their lives.
When a person is diagnosed with chronic kidney or renal failure due to damage or disease to the kidney, dialysis is used to remove waste (diffusion) and unwanted water (ultra-filtration) from the blood of the patient whose kidneys are not functioning adequately.
Dialysis can allow individuals to live productive and useful lives for many years provided adequate treatment and regulated diet and medications are available, affordable and applied.
THE GHANA POLICE HOSPITAL DIALYSIS CENTER
The Ghana Police Hospital Dialysis Center was established through a public private partnership between Health Education on Wheels Inc. and the Ghana Police Hospital. The centre was born through the collaborative efforts of Mr Bill Addo, Dr. and Mrs. Anim-Addo all stationed in the United States of America and Mr Nyante, the current Chairman for Health Education on Wheels.
The unit is located on the second floor of the Hospital Annex building and began operations in 2011. The center was officially opened by the former Inspector General of Police, Mr. Mohammed Alhassan.
Our vision is to provide affordable and accessible dialysis treatment services in a friendly environment run by competent and professional staff.
Data for year 2017 indicates the total number of dialysis treatments undertaken was 2,479 with the highest number of clients recorded in March as 34. The highest number of dialysis treatments in a month was 309. We serve clients from Ghana, West Coast of Africa and also provide services to international clients visiting Ghana for a period of time. Four of the patients have gone on to have kidney transplants, only possible from the good care they received at the dialysis center. Approximately 50% of the patients who undergo dialysis are staff of the Ghana Police Service.
WOMEN AND CHRONIC KIDNEY DISEASE
Chronic kidney disease (CKD) is a worldwide public health problem with adverse outcomes of kidney failure and premature death. CKD affects approximately 195 million women worldwide and it is currently the 8th leading cause of death in women, with close to 600,000 deaths each year.
The risk of developing CKD is at least as high in women as in men, and may even be higher. According to some studies, CKD is more likely to develop in women compared with men, with an average 14% prevalence in women and 12% in men.
However, the number of women on dialysis is lower than the number of men.
At least three major reasons are recognized so far: CKD progression is slower in women compared to men, psycho-socioeconomic barriers such as lower disease awareness lead to late or no start of dialysis among women and uneven access to care is a major issue in countries with no universal access to healthcare.
Kidney transplantation is also unequally spread, mostly due to social, cultural and psychological aspects: even in some countries that provide kidney transplantation and equitable treatment for men and women, women tend more often to donate kidneys and are less likely to receive them.
Women are at higher risk for acquiring Lupus Nephropathy & Kidney Infection
Some kidney diseases, such as lupus nephropathy or kidney infection typically affect women. Kidney infections (as most urinary tract infections) are more common in women and the risk increases in pregnancy. To ensure good results, as most renal diseases, diagnosis and treatment should be timely.
Kidney Disease & Pregnancy
CKD is also considered a risk factor for adverse pregnancy outcome and reduced fertility. Women who have CKD are at increased risk for negative outcomes for the mother and the baby; pregnancies in women with advanced CKD are most challenging with high rates of hypertensive disorders and preterm births. They may have reduced fertility but conception is possible, even if infrequent, on dialysis.
In successfully transplanted women, fertility can be restored and chances of successful birth increase. There is a clear need for higher awareness on CKD in pregnancy, to timely identify CKD in pregnancy, and to follow-up women with CKD during and after pregnancy. In this respect, pregnancy may be also a valuable occasion for early diagnosis of CKD, thus allowing planning of therapeutic interventions.
In turn, pregnancy-related complications increase the risk of kidney disease: pre-eclampsia, a syndrome in which a defect of the implantation of the placenta affects normal kidneys inducing hypertension and proteinuria, is one of the 3 leading causes of maternal mortality. Preeclampsia, septic abortion (infection of the placenta) and post-partum haemorrhage (major bleeding after giving birth) are leading causes of acute kidney injury in young women, and may herald future CKD in survivors.
The burden of those maternal complications is particularly high for women in developing countries, due to insufficient access to universal and timely prenatal care, to improper management of women with preeclampsia, and to lack of availability of dialysis for acute kidney injury.
There is a clear need for higher awareness, timely diagnosis and proper follow up of Chronic Kidney Disease in women and in pregnancy. This allows for planned therapeutic interventions.
Health Education on Wheels in collaboration with the Ghana Police Hospital and the Paramount Chief of Osu and President of the Greater Accra Regional House of Chiefs, Nii Okwei Kinka Dowuona VI, will conduct FREE screenings for women and girls on the 8th March 2018.
The Chairperson of the Bilateral Committee of the Kidney Dialysis Centre and an Eminent Scientist, Dr Sylvia Anie comments quote “There is a clear need to address issues of inequitable healthcare access for women across Ghana who need dialysis care . We should collectively intensify advocacy for increasing awareness, education and empowerment for women and girls. We need to change negative lifestyle habits, take control, become better informed and aim for early detection….” unquote.
The Medical Director of the Police Hospital, DCOP Dr Iddi Musah remarks quote “We shall continue to strengthen our public private collaboration with Health Education on Wheels and initiate expansion plans at the Dialysis Center. We intend to increase the number of dialysis machines in order to address the increasing client load and we will continue to provide a service of quality.” unquote.
Support has been provided to the Dialysis centre in various ways by corporate bodies and individuals including Enterprise Insurance, D-Med, Unibank, Amex Pharmaceuticals, Kalyppo Aquafresh and its Patron Mr Charles Laba.
By: Dr Sylvia Anie CSci FRSC FRSM and David Apinga