Kidney disease crisis!

JAMAICANS suffering from chronic or end-stage kidney disease must fork out up to $2 million a year for treatment (dialysis) to remove excess fluid and impurities from the bloodstream or face an unthinkable alternative — death.

Even at that, 3,000 people are currently on dialysis at least twice per week, typically paying $7,500 per treatment at the University Hospital of the West Indies (UHWI), or between $10,000 and $17,000 per treatment at private institutions.

There is no charge for dialysis at public hospitals, but more often than not there is an acute shortage of dialysis machines, leading to long waiting lists and people expiring before their names are reached.

Jamaica’s pre-eminent kidney disease specialist, Dr Everard Barton, painted this grim picture for the Jamaica Observer, sounding even more dire as he urged Jamaicans to change to healthy lifestyles to prevent unnecessary fatalities.

He pointed to troubling findings from the Caribbean Renal Registry whose surveys showed that as much as 60 per cent of people with chronic cases of diabetes and hypertension suffer kidney failure in seven English-speaking regional countries, including Jamaica.

“There is a long list of people who, even if they could pay the astronomical cost involved, must wait to begin treatment for renal failure because there [are] not enough dialysis machines in the country,” lamented Dr Barton, emeritus professor of medicine and nephrology at the UHWI and The University of the West Indies.

Barton, who is now in his fourth decade in nephrology (the study of kidney diseases), spoke with the newspaper after reader interest piqued when it carried the story November 10, 2021 that the elder son of late Prime Minister Edward Seaga, Chris was urgently in need of a kidney to save his life.

Chris and the Seaga family have since asked that the attention be turned to the many Jamaicans who are battling chronic kidney diseases, some of whom either can’t afford treatment, can’t get access to a dialysis machine, or need kidney transplantation but can’t find donors.

Dr Barton was not clear on the total number of people on the waiting list for dialysis but said there were 800 at the UHWI and 500 at the Kingston Public Hospital alone.

The UHWI has between 16 and 17 dialysis machines which have to operate at a frenetic pace.

Professor Barton said that, of the 3,000 lucky enough to be on dialysis, a large number of them are at the stage where they should be candidates for kidney transplantation, but because they had “multiple adverse medical problems” the procedure would likely not help them.

Between 40 and 70 per cent are viable candidates for transplantation but are waiting and hoping for a donor, with no clear sign of when someone will show.

When the rare donor shows up, the next obstacle is the cost. People who can afford it go overseas and pay between US$120,000 and US$150,000 for the procedure. At the UHWI it is subsidised, but patients must meet up to 50 per cent of the cost, still a hefty sum for most people.

“It is costly in the first year at UHWI because there [are] also the chemicals and drugs for maintaining kidney health and preventing rejection of the new kidney. But, after that, the cost goes down drastically,” he said.

The combination of despair and the heavy cost explains Dr Barton’s decided preference for prevention over transplantation.

He said that every country in the world complains about the high cost of expanding their dialysis units and for transplantations, and in that respect Jamaica was no exception.

“We need to lead a healthy lifestyle in which one reduces the intake of things like fats, salt, watching the diet, weight and cholesterol levels, and doing blood pressure and urine tests annually to identify high-risk factors for kidney disease so we can catch them early or intervene to slow down the progress of disease,” he urged.