By Chioma Gabriel, Deputy Editor
Professor Martin Anthony Chike Aghaji is a specialist in Adult and Paediatric Heart Surgery, Thoracic Surgery, Liver Surgery, Kidney Transplantation and Nuclear Medicine.

In the area of Open Heart Surgery, he has extensively studied the complex methods of clinical diagnosis/surgery and worked on simplifying these methods such that they could be adopted in a developing country like Nigeria and the African Sub-region.

At the international level, Professor Aghaji has been the African Regional Representative and steering committee member of the International Society of Cardiothoracic Surgeons since 1996. He is a member of the African Committee on Cardiology in the American College of Cardiology. He has also been an examiner in the Postgraduate Surgical Examinations both local and international and has examined in the Part 1 and 11 West African College of Surgeons.

To what would you attribute the rising incidences of kidney diseases?

One would say that so many factors are responsible for this. One is that we can make diagnosis now, more than we used to do in the past. Secondly, one of the commonest causes of chronic renal failure is hypertension, systematic chronic hypertension. I can tell you that 50 per cent above the age of 50 years in Nigeria are probably hypertensive.

The issue of high hypertension in Nigeria is getting higher. Number three, patients who have hypertension are not well treated in Nigeria, they are not well-evaluated because a lot of people who are hypertensive don’t go for medical check-up. Hypertension is a silent killer and it brings a lot of complications. Nigerians don’t seem to care if they are hypertensive or not and even when they know they are, some hardly follow-up on the treatment.

That is deadly. Then, some of the people who have been diagnosed to have hypertension cannot afford the treatment. Hypertension requires that you take the treatment everyday, usually for life and the drugs are very expensive.

All the drugs?

Well, there are variety of drugs for hypertension. The cheaper ones have more side-effects than the expensive ones. Now, if you give the patients the expensive drugs, they cannot afford it.

But if you give them the cheap ones, they have a lot of complications and it affects the males more than the females.

How?

It brings about erectile dysfunction and kills a man’s libido. And when they discover this, they abandon the drugs. The other thing is that majority of drugs used for hypertension are fake. A lot of hypertension drugs are being smuggled into this country and they are fake or expired. So, these are some of the reasons we have chronic renal failure.

The other thing that increases the rate of kidney diseases is the use of bleaching cream by both women and men. These days men also bleach and use of bleaching cream can increase rise in renal failure.

Does it have anything to do with the normal food we eat on daily basis?

Well, other foods eaten on daily basis can contribute and that is why these days, we tend to control what we eat. These days, it is advisable to stay away from fried foods, packaged foods, carbohydrates and processed meals.

We like to be in air-conditioned places: cars, homes, bedrooms, offices and that is not too good. Room temperature is the best and we should be aware because these can help accelerate the problems.

But children are also increasingly getting affected?

In the case of children, we found out that when children have kidney diseases, it is due to other things. You’d found out that children have been exposed to some form of infections. Some throat infections, when they happen, the child may not even know about that or may ignore it.

Some people don’t treat malaria in their children very well and these can bring about other diseases. It depends on how much they recover fully from these diseases or the untreated infections keep eating the inside and causing other things.

Some children are also born with abnormal genes which affect the kidney functions, that is, hereditary diseases. In such cases, you cannot change the genes but you can evaluate the children with the aim of preventing the retrogression in a more serious form.

Can you quantify the number of people who go down with this disease annually?

I can’t because we are lacking in this country the issue of data. We don’t have data because the system has not encouraged data collection. In developed countries you can have such data. But we don’t have data. What you need to know is that everyday in newspapers, television and radio, you read, see and her people soliciting for help to treat the ailment. In some rural places, no diagnosis are made and where they are, no treatment is given and the patients die.

Why is it that the treatment cannot be done in Nigeria, everybody goes to India and they make appeal on pages of newspaper or TV requiring N7 million or more for treatment?

It’s really unfortunate that our government has not done enough. It is really a shame for the nation not to have done enough on this disease. Let me give you some insight. If you work in the United States, you’d find that there are patients with kidney problems. Even in Europe. But 90%/95% of the patients with chronic renal failure live on dialysis for ever.

However, in these countries, the system supports them very well. They don’t pay for dialysis. There are centres set up by their governments for every infirmity and chronic renal failure. So, these patients live their normal lives.

They go to work or to school and on their way back, they come with their files. I’m telling you this because I have lived and practiced Medicine in the United States and have worked in one of the centres. When the patients come into the centres on their way back from work, they would commence their dialysis and be doing their office work if they have take-home assignments from their work places.

The students amongst them could be reading their books or writing their thesis while we are dialysing them and they come in two times a week. That is how patients live in the civilised countries. Only 5 per cent would go for transplantation.

In our country, the story is different. Even dialysis is expensive but there, dialysis is taken up by the insurance companies. The person does not pay. I have a classmate in the United States who has been on dialysis for 25 years and he is still alive.

He developed renal failure when we were in school. He s getting old right now and he is alive but on dialysis. So, over there, only about 5-10 per cent would go for transplant. But in Nigeria, it is a different ball-game.

So, how safe is kidney transplant?

The best kidney transplant is that of an identical twin. Remember we re talking about another human beings kidney and we all have two kidneys but we don’t have the education to understand that just with one kidney, one can live a perfectly normal life.

I can tell you scientifically that in history of kidney transplants in the world, nobody has died because he donated one kidney. People have accidents and lose one kidney and are living perfectly well with one. So, it is important to understand this fact because we have come to realise that in Nigeria, people are very afraid to donate their kidney and that is due to ignorance.

They think that if they give out one kidney they will die or that if they give out one, something will happen to the remaining one and they will die but it never happens. So, we need a lot of education on why they should donate kidneys.

Are you saying that one’s system can reject the kidney of an outsider of the same blood group?
Of course. That’s what I’m saying. That’s why I said the closest match is an identical twin because they have the same genetics and are the same match. They don’t reject. And you can get from your brother.

What should be done to control the epidemic?

The government must set up cardio-reno centres in at least in each geo-political zones and Abuja. Other countries have them, even countries like Ghana, Ivory Coast, why should Nigeria with a population of 140 million people not have it? Cardio-reno is a centre that would address issues of cardio-vascular diseases and chronic renal diseases because they work together.

I remember I once told you that our former President had a kidney problem and that would have been a perfect opportunity to have set up one of such centes and see how we go because if we do it in this country, it wold be absolute more cheaper and we need to educate our people that when they done one kidney, they cannot die but live perfectly well on the other.

And in Nigeria, there are usually many brothers and sisters to choose from, not like in US or Europe where couples prefer one or two kids. So, to do a transplant in Nigeria is easier and cheaper if the equipments are here. It is easy to do a transplant and the sooner we do it, the better.