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Kidney failure- Auma urgently needs a Transplant

By Vision Reporter

Added 28th June 2009 03:00 AM

It started like a mild fever but as the days went by, Pamela Auma’s condition only worsened. “My body began to swell. I started vomiting and experiencing chest pain. Breathing became a problem,” she says.

It started like a mild fever but as the days went by, Pamela Auma’s condition only worsened. “My body began to swell. I started vomiting and experiencing chest pain. Breathing became a problem,” she says.

By Stephen Ssenkaaba

It started like a mild fever but as the days went by, Pamela Auma’s condition only worsened. “My body began to swell. I started vomiting and experiencing chest pain. Breathing became a problem,” she says.

At first Auma thought it was malaria, but after an ultrasound scan, it was discovered that the 24-year-old graduate teacher had kidney failure.

This was June last year. Auma received treatment at Lacor Hospital in Gulu until December 2008 when she was transferred to Mulago Referral Hospital.

It was devastating news for Auma’s peasant family. “We did not know where to get the money for her treatment,” says Alex Oming, Auma’s father.

At Mulago, Auma has been undergoing treatment, which among other procedures, requires dialysis, a medical procedure that involves continuous removal and purification of blood from the body.

According to Dr. E.R Ssekasanvu, a nephrologist at Mulago Hospital, dialysis costs sh900,000 per week. “This does not include other essential drugs that go with it, which cost about sh1.2m a month.”

A nephrologist is a physician who has been educated and trained in kidney diseases, kidney transplantation and dialysis therapy.

It has been a difficult time for Auma’s family who sometimes rely on financial assistance from friends to keep Auma receiving treatment.

We have spent over sh7m on treatment. We have run out of options,” says Oming.

On April 30, Dr. Ssekasanvu referred Auma to India for a kidney transplant. This, in the long run, will be a cheaper option which will also enable the young lady to lead a stable life for some time,” he says.

It is, however, a very expensive option for Auma’s family. According to a quotation from the Institute of Kidney Diseases and Research Centre in Gujarat, India, where Auma has been referred for the transplant, the entire procedure, including travel and upkeep for the patient and donor will cost 550,000 Indian rupees (about sh35m).
“We appeal for help from Good Samaritans,” Oming says.

A fairly common condition
In Uganda, renal failure is fairly common.

A senior nephrologist at Mulago Hospital says although there are no statistics, the national hospital receives about 5,000 patients with kidney problems every year.

A study carried out on the prevalence of renal disease in outpatients with HIV at Mbarara Hospital revealed, without giving specific figures, that prevalence of the disease in developed countries is higher than that in developing countries.

In the US, for example, over 200,000 people suffer from kidney failure.
Unfortunately, there are not enough facilities to treat patients in Uganda.

We have only six dialysis machines and a handful of staff. This often hinders our work,” says Dr. Ssekasanvu.

Diagnosis is based on laboratory testing of renal function, sometimes followed by renal biopsy (where a tiny piece of the kidney is removed and examined under a microscope).

Treatment is primarily directed at the underlying condition, but includes fluid and electrolyte management, erythropoietin for anaemia and often dialysis or transplantation.

Other important tests include blood and urine tests to check the functioning of the kidneys, a chemistry screen to establish levels of sodium (salt), potassium and calcium.

An ultrasound should also be done to establish the state of the kidneys.

Treatment
This depends on age, duration and level of kidney failure. In its early stages, the condition can be arrested. However, if it is advanced, it cannot be reversed.

This calls for dialysis and, more effectively, kidney replacement, which requires a donor, usually a relative. Other treatment options include:

Replacing lost fluids, such as water, blood and restoring blood flow to the kidneys.

Discontinuing of any medications that may be causing the problem.

Treating kidney disease that is causing damage to the kidneys by using plasma exchange or other medicines, depending on the specific disease.

Using medicines to stop the immune system from working.

Remove or bypass a blockage in the urinary tract.

Safeguard against the disease
Dr. Ssekasanvu suggests that sometimes renal failure occurs early in people’s lives, but is usually detected much later.

He says if the problem is detected and treated early, it can be arrested before it worsens. He offers the following safeguards:

Regular kidney check-ups, especially for people with diabetes and/ or blood pressure. Many times people with these diseases present with renal failure without knowing it.

Desist from taking drugs without medical advice. Dr. Ssekasanvu says with self-medication, one can take drugs that contain dangerous chemicals, which may lead to kidney failure.

People should avoid smoking and excessive drinking of beer as these also predispose them to renal failure.

Auma can be helped through Stanbic Bank Makerere Branch
Account Number 0121019983401

Kidney failure- Auma urgently needs a Transplant

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