Every so often, a flyer appears on social media appealing for help for someone with kidney failure. There is a photograph, a short account of the patient’s suffering, a bank account number and a plea for money. We share it, donate what we can and pray. Then another flyer appears. And another.
The flyers raise a question we rarely ask: why do so many families end up pleading with strangers to keep a loved one alive, and what could we have done before they reached that point?
As a doctor, I have seen very young people with end-stage kidney disease. They should be looking forward to years of productive living. Instead, they face lifelong medication and regular dialysis. What I see in my practice is not national data, but it has convinced me that awareness is our most underused tool.
A disease that hides
Chronic kidney disease (CKD) is the gradual loss of the kidneys’ ability to filter waste and excess fluid from the blood. These two bean-shaped organs also help control blood pressure and balance the body’s salts. When they fail, the effects reach the whole body. According to estimates, about 25 million Nigerians may be living with CKD, with the burden greatly impacting young and middle-aged adults.
Its most dangerous feature is silence. A person can feel well while damage builds. By the time swollen feet or face, persistent tiredness, foamy urine or changes in urination appear, much of the kidneys’ function may already be lost. Yet the absence of symptoms does not mean the kidneys are healthy, which is why so many patients reach hospital late.
Nor is CKD only a disease of old age. Young adults, teenagers and even children can develop it.
What speeds up kidney damage?
Some causes are inherited or unavoidable. But many of the factors that accelerate damage are common, and some are within our control.
High blood pressure. Persistently high pressure damages the tiny blood vessels in the kidneys, and kidney disease in turn raises blood pressure, creating a vicious cycle. Many Nigerians, including young adults, have hypertension and do not know it.
Diabetes. Excess sugar in the blood injures the kidneys’ delicate filters over time. The longer it stays poorly controlled, the greater the risk.
Painkillers and other medicines. Prolonged or frequent use of some over-the-counter painkillers, especially without medical supervision, can harm the kidneys.
Unregulated herbal preparations. Concoctions of unknown ingredients and dosage may be toxic to the kidneys. ‘Natural’ does not mean ‘safe.’
Late diagnosis and untreated conditions. Ignoring early warning signs, or stopping blood pressure and diabetes drugs because ‘I feel fine,’ lets damage progress unchecked.
Family history. A close relative with kidney disease raises your risk.
Still, it would be wrong to blame every case on lifestyle or misuse. Some people develop CKD despite sensible precautions. The aim is not to assign blame but to reduce risk wherever we can.
When prevention fails
CKD does not always progress to kidney failure, and early care can slow it in many patients. But when it does progress, the costs can overwhelm a family. Dialysis, which does the kidneys’ filtering work, is rarely a one-off expense. Most patients need several sessions every week, indefinitely, unless they receive a transplant. Media reports put the cost at tens of thousands of naira per session, before medicines, laboratory tests and transport. Public hospitals may charge less, but not all have dialysis units, and those that do can be distant or overstretched. A transplant is costlier still and requires lifelong medication.
So, families sell property, drain savings and borrow, and caregivers leave jobs to nurse a relative. The flyer is where this private struggle becomes public.
What can we do?
Get checked. Everyone should have their blood pressure measured regularly. Anyone with hypertension, diabetes or a family history of kidney disease should ask a health professional about simple blood and urine tests, which can reveal damage before symptoms do. Not everyone needs frequent kidney tests, but people at risk should not wait for symptoms.
Treat existing conditions properly. Take prescribed medication consistently, even when you feel well. Some blood pressure and diabetes drugs actually protect the kidneys.
Be careful what you swallow. Avoid self-medicating with painkillers, and speak to a doctor or pharmacist before using herbal remedies.
Live healthier. Eat less salt, keep a healthy weight, stay active, avoid tobacco and limit alcohol.
But individual effort is not enough. A health system must support it: public awareness campaigns, screening and continuous care for hypertension and diabetes at primary health centres, and better national data on kidney disease. Where prevention comes too late, patients need financial protection. The government has announced subsidised dialysis at some federal hospitals. The question is whether it is reaching patients in practice, and whether it is enough. Prevention and protection are complementary responsibilities, not competing ones.
The next time a flyer appears on our phones, let us respond with compassion. But let us also ask a different question: what can I do today to protect my own kidneys and those of the people I love? Check your blood pressure. Share this message as readily as you share a flyer.