ACCORDING to the Diabetes Association of Jamaica website, there are 400-600 new cases of chronic renal failure per million of the population in Jamaica per year, and diabetes mellitus contributes significantly to this. These patients are usually made to undergo haemodialysis, where a dialyser or artificial kidney is used to remove waste and excess fluid from the body.
“Kidney dialysis is a lifelong condition where persons, unless they get a kidney transplant, will have to get dialysis two or three times per week to clean their system,” explained Lurline Less, executive chairperson of the association.
Less said managing hypertension and diabetes is crucial to the prevention of kidney problems which also create other health issues for individuals. In women, for example, kidney failure oftentimes results in them being less fertile and could impact on their menstrual cycles.
“It’s not just the dialysis treatment, it goes far beyond that. There are other complications surrounding the kidney problems. You might have heart problems, eye problems, foot problems. So it’s really a complex issue for the persons overall,” she told All Woman.
Professor of medicine and nephrology, Dr Everard Barton, said that while men on dialysis sometimes encounter issues such as erectile dysfunction, women oftentimes experience other issues.
He explained that the menstrual flow is affected primarily because kidney disease sometimes lowers the blood count and this in turn makes some women become very anaemic.
“If you are having very, very heavy periods, it would worsen that anaemia, so you would have a lack of hormone produced by the kidney, plus with the heavy period and so on, sometimes we have to call in the gynaecologist,” he said.
Dealing with renal failure also sometimes impacts on the sex life of couples as it sometimes creates self-esteem issues for the person living with this illness.
“Some women, if they are having dialysis through the belly, which is peritoneal dialysis, there is nothing wrong with still having sex, but some of them psychologically feel that because they have this tube through the belly, they don’t want to have sex,” explained Dr Barton.
Being on haemodialysis can also result in financial ruin for families when compounded with sourcing the funds for medication and for transporting sick relatives to the hospital.
“It’s a tremendous strain not only for the persons with kidney failure, but for the family as well,” said Less.
To reduce the financial burden for families, the Diabetes Association offers assistance to persons under 26 years old under it’s Life for a Child programme. The programme currently assists 300 diabetic children and young adults with insulin, syringes, blood glucose monitors and test strips as well as A1c testing three times per year at no cost.
Although kidney disease is a lifelong illness, it is still possible to work and lead a normal life. By leading a healthy lifestyle and following your doctor’s advice, you can reduce your chance of worsening your kidneys. One major change in going forward after diagnosis will be your diet.
“We may have to limit how much protein they take, but not to the level where they become malnourished. Because the kidney is not getting rid of potassium, we have to limit the potassium that they take, so we may say, well don’t drink coconut water, don’t eat ripe bananas and things like citrus drinks,” said Dr Barton, who explained that a patient’s fluid intake would also be reduced.
Patients are also taught how to leach the phosphorus from their food since the malfunctioning kidney cannot get rid of this nutrient.
“Like for potatoes and yams and dasheen, we may teach them to peel them, soak them overnight and half boil them, throw away that water, and then boil them to the finish and this helps to leach out phosphorus,” explained the doctor.