Nigeria: Kidney Disease Patients Groan Over Cost of Dialysis

Nigerians suffering from kidney diseases are groaning over the high cost of treatment and absence of functioning dialysis machines at the various kidney treatment centres, Daily Trust investigations have shown.

The high cost of treatment and paucity of facilities is affecting about 25 million Nigerians who have kidney failure, according to the Nigerian Association of Nephrology.

Even though most of the state governments in the north have at one time or the other established kidney treatment centres equipped with dialysis machines and other medical consumables, findings, however, revealed that most of these machines are poorly maintained with the majority of them out of order.

The cost of dialysis (the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions naturally), which is done at least thrice per week, is beyond the reach of the renal patients who are mostly poor.

Only 3 of 18 dialysis machines work in Sokoto

In Sokoto state, for instance, of the 18 machines at the renal and dialysis centres of Usmanu Danfodiyo University Teaching Hospital (UDUTH), and the Specialist Hospital Sokoto, only three are currently working.

The renal centre at UDUTH established in 2007 has seven machines but only one is presently working while only two of the 11 machines at the specialist hospital are working.

Head of UDUTH’ dialysis centre, Dr. Muhammad Makusidi told Daily Trust that six machines had developed technical problems due to heat, unstable electricity, among other maintenance problems. “The machines had almost outlived their time as they had been there since the place was established over 10 years ago,” he said.

On patients’ attendance, Makusidi said the centre treats an average of two to four patients in a day. The poor turnout is “because of the cost which not all dialysis patients could afford and the government was not subsidizing for anybody.”

The centre charges N25,000 per dialysis session, but the cost goes down to N17,000 in the subsequent sessions, the medical doctor said.

Dr Makusidi said a patient requires at least three sessions in a week, but the high cost forced many patients to undergo one session per week or two in a month.

Daily Trust gathered that specialists’ hospital – owned by the Sokoto state government – that patients are only charged N15,000 per session; that is why patients were trooping there.

A staff of the hospital said they attend to four patients daily, “unlike when all the 11 machines were working, we treated like 22 patients in a day. Every machine takes care of two patients in a day.” Dr Makusidi said there were no experts who could repair dialysis machines in Sokoto.

No free dialysis in Yobe despite governor’s directive

In Yobe State, the renal failure patients are groaning over ‘high cost’ of dialysis sessions. Despite a directive by the state Governor Ibrahim Gaidam for free dialysis sessions for indigenes of the state, it is yet to take off.

Daily Trust visited the dialysis centres at the Yobe State University Teaching Hospital (YSUTH), Damaturu and spoke to patients who said that they were still bearing the brunt of the cost of the dialysis sessions despite their poverty-stricken conditions.

“The governor’s directive has not been executed. Perhaps, it is mere politics. And the elections are over. The politicians have moved on,” said a lady who brought her mother to the hospital for dialysis. It was gathered that the state government had approved N5 million monthly to upset the dialysis for one year.

The health officials at the centre refused to speak to our reporter because of ‘sensitivity’ of the matter. Yobe state commissioner of health Muhammad Bello Kawuwa didn’t pick several calls nor replied to the text messages sent to his mobile on why the governor’s directive was not carried out more than two months after it was issued.

In Borno State, the University of Maiduguri Teaching Hospital Kidney Centre has 21 dialysis machines, 15 of them functional and 6 not functional, the Director of the Centre, Dr. Ibrahim Ummate told Daily Trust in Maiduguri.

The Associate Professor of Medicine mentioned the charges for dialysis per patient as N40,000 weekly or N20,000 twice weekly.

He said presently 25 patients are on admission at the centre.

Daily Trust reports that in October last year a Kidney Complex with digital Dialysis Machines was funded and donated to the Borno State Government by a philanthropist from Osun state, Abdulkabir Adisa Aliu, who is the Managing Director of Matrix Energy Ltd through his Foundation.

Borno State Governor Kashim Shettima said while inspecting the project that the government would soon begin free dialysis and other kidney related medications in the state.

Long queues, power outage mar Katsina free dialysis

In Katsina state, large number of patients and poor electricity supply have overwhelmed the free dialysis sessions offered by the state-owned general hospital.

The centre has only five machines which provide free services to patients with renal failure. However, Daily Trust gathered that power outage has affected the machine.

During a recent visit to the centre, our reporter saw a long queue waiting for their dialysis.

A German construction company, Julius Berger, built and donated the dialysis centre to the state during the tenure of Umaru Yar’adua as governor, who also suffered from the renal disease.

Patients who spoke to Daily Trust said accessing the free dialysis is difficult because of the number. “You have to wait to be enrolled on the queue irrespective of your condition. Some patients are wheeled to the centre unconscious,” a staff of the centre said.

The dialysis in Katsina is also available at the Federal Medical Centre even though it is not free. The FMC charges N36,800 for the maiden session of dialysis, while subsequent sessions cost N15,500. But very few patients in Katsina can afford this much. The centre has four machines.

High cost bar patients from Kano’s 40 machines

In Kano state, there are at least 40 dialysis machines located at Aminu Kano Teaching Hospital (22), Abdullahi Wase Specialist Hospital (8), Muhammadu Buhari Ultramodern Hospital Giginyu (6), as well as the private facility at UMC Centre in Kabuga (4).

Of the Aminu’s 22, 18 are working, our reporters said. Those of Giginyu hospital are brand new. Despite this apparent availability, the cost of dialysis has created a wall between the patients and machines.

About 80 percent of the patients undergoing dialysis at Aminu Kano hospital between 2014 and 2018 have died because they could not afford the recommended sessions of dialysis, chairman of Kano State Kidney Foundation, Alhaji Wali Ado Rano told this newspaper.

He said lack of subsidy by the government is their major concern. “There is no any form of subsidy by the government apart from the structures and facilities it provided. Aside from that the cost of dialysis is born by the patients.

“The only person that identified with us in this predicament is A. A. Rano. He donated items like dialysers and other consumables every three months to the hospital for the patients and as a result of that the cost is reduced by almost 60 percent. So instead of N17, 000 regular charges you pay N5,000,” Wali said.

Dialysis facilities at the Aminu Kano and Abdullahi Wase are fully public, while that of Giginyu is a partnership between private investors and the government.

Daily Trust findings revealed that the first session of dialysis at Aminu Kano hospital costs N27, 000 and subsequent sessions cost between nine and 10,000 because some of the consumables are recycled for subsequent sessions.

At Abdullahi Wase, the first session goes for N10, 000 and subsequent sessions N5,000 due to government subsidy. Despite this, the patients, who are mostly far below the poverty line, cannot still afford it.

A recent survey conducted by at Aminu Kano hospital shows that 26 percent of residents of Kano metropolis have some forms of abnormality in their urine or blood cells that suggest an imminent risk of kidney disease.

Cost of consumables makes dialysis unaffordable – Doctors

The head of Nephrology unit at Aminu Kano hospital, Professor Abdu Aliyu said, however, said facilities are not the main issue in Kano at the moment, but the cost of accessing the care by those that need it.

He said the main issue in Aminu Kano teaching hospital with 22 machines “is the affordability, how many patients with any stage kidney disease that need kidney replacement therapy that can afford it? That is the main issue, one machine can take care of many people, you come and take the treatment and go like in our area we do 24-hour services morning afternoon and night shifts.

He attributed the high cost of dialysis to the relative cost of non-recyclable consumables used in the therapeutic process.

He said some of the consumables used in dialysis are not recyclable “Some of them because we are black people, we recycle them like the dialiser and the blood tube lines. We use them many times,” he said.

Professor Aliyu said “we have the technology that allows us to wash the dialiser and put it in disinfectant and keep it for you when you come the next two-three days, we wash it and use it again. This innovation is to save the cost but the issue is the cost of consumables that is making dialysis unaffordable to many patients that have chronic kidney disease.”

Manager of the Abubakar Tafawa Balewa University Teaching Hospital Renal Centre, Aminu Wagani told Daily Trust that ideally a patient is supposed to have three sessions in a week to clean his body of toxins accumulation.

“Unfortunately, some patients cannot afford to have the ‎three sessions. Some are having two, while some wait until they have money to come,” he said. Wagini said that is “why some people will be taken here unconscious because there are so many toxins in their body which have not been filtered since their kidneys are not working well.


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Publish date : 2019-04-02 10:43:24

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