HEALTHY DISCUSSION

Living through a kidney transplant

From the diagnosis to the search for a donor and a hospital, it is stressful

In Summary

• A kidney transplant remains the best medical solution for any form of kidney condition

Surgery in progress
Surgery in progress
Image: COURTESY

‘Your kidneys are failing and you require to be on dialysis or a kidney transplant’. Those words right there could, in my opinion, qualify to be used as the Ritcher scale for bad news.

I received this news during a random health checkup. Damn! How? Why me? Why now? These were the first words that came to my mind. Many questions ran through my mind and the many answers I required were out of reach at that particular time. In any case, I was distraught enough not to understand any of them.

Your kidneys filter all the toxins that are in your blood and send them to your bladder, which subsequently remove the toxins through urine. Important organ, right? With very vital function in your body, that is why when your kidneys are failing and this is left untreated, it could be life-threatening.

 

My decision to seek medical attention and fight this condition led me to Kenyatta National Hospital, which is a centre of excellence for kidney transplants. The nephrologists and nephrology nurses in the hospital play a very critical role in aiding kidney patients and their families cope with the condition; they are Godsent.

My doctors, John Ngigi of Kenyatta National Hospital and Ahmed Twahir of Parklands Kidney Centre, were most helpful in getting me to understand what I was going through and what it would take to rise above my condition. Among the options, including a weekly dialysis, the two doctors advised strongly to undergo a kidney transplant.

A kidney transplant is one of the two renal replacement therapies available when one’s kidneys fail. It involves placement of another kidney, from your donor, in the patient’s body, the recipient. A kidney transplant improves the patient’s quality of life. To me, a transplant was a new lease of life, a huge relief from the possibility of death and freedom from being tethered to a dialysis machine twice or thrice a week not, to mention a restricted diet.

Because my condition was discovered early, I still had some kidney function and this allowed me to prepare both financially and emotionally, a luxury that most of my friends and colleagues at Renal Patients Society, which I head, did not have when they were first diagnosed. From this, I learnt the importance of routine checkups, which I now advocate as a way of keeping in touch with your health.

My next task was to look for a kidney donor. My sister Grace, who I will forever be indebted to, donated one of her kidneys as she was a perfect match. With the kidney available for transplant, I now embarked on searching for a good hospital to have the kidney transplant surgery, and this took me all the way to India.

Eventually, I settled on Kenyatta National Hospital for many reasons, but mainly because I would undergo the surgery at the comfort of my home country and under the care of very qualified doctors. With the guidance of the KNH Transplant Coordinator, Nancy Wangombe, I went through the pre- transplant preparations and screening and I was ready for my transplant surgery.

I thought that was all, that I would have the transplant and life would go on. What I did not know is that the transplant surgery is just one event, whereas living with a foreign kidney was a lifetime affair. Of the things required after a transplant is taking medication religiously without fail, quite a daunting task at the start. There is also regular clinics and lab tests that one must undergo to monitor the performance of the new kidney. All symptoms of illnesses are also monitored closely. Over-the-counter medications and supplements are out of the picture, not unless recommended by the transplant team of doctors. No miti shamba and other fad diets for me.

 

With the ever-present risk of infections, a high level of hygiene must be observed after a transplant. This involves regular washing of hands and being mindful of what and where I eat. Raw foods are discouraged, so I have learnt to give salads and kachumbari a wide berth, except if I have prepared them or I trust the source. Other sources of infections can be crowded places; for instance, funerals and churches, not forgetting bus stops.

The first six months after my transplant surgery, I had to completely keep off these places because the new kidney was still very much susceptible to all the risks that affected the native kidneys. The medication taken after kidney transplant lowers the general immunity of the body, leaving one prone to diseases, for instance, skin cancer, due to exposure to the sun’s UV rays, and to avoid this, a sunscreen lotion is crucial.

Of all the benefits of a kidney transplant, flexibility of diet is the most immediate. This is something dialysis patients do not have the luxury of enjoying. This luxury must, however, be enjoyed with moderation, as one of the side-effects of some post-transplant drugs is weight gain. Regular clinics and lab tests are also important.

My lab tests at Lancet Pathologists free me from the long queues or return trips to collect my result by sending them via email. The regular clinics at KNH and Parklands Kidney Centre are my moments to catch up with my dependable caregivers. There is nothing more fulfilling than being in the care of people wholly invest in their patients’ well-being.

The cost of post-kidney transplant drugs is challenging to myself and other transplant patients; they are not cheap. In my case, the starter dose amounted to Sh60,000 per month. This cost usually drops with time but remains way too expensive for a lot of patients, most especially given that the National Hospital Insurance Fund does not cater for these costs. NHIF pays for two sessions of dialysis per week and covers transplant costs for up to Sh500,000, but does not cover for the cost of drugs for transplanted patients. This may be a great hindrance for patients to seek transplant services and opt to remain on dialysis.

Information around kidney disease, the symptoms, causes and how one can protect themselves is needed. My search for more details about the disease was discouraging. Even though doctors are helpful, our sessions with them are limited by time and money.

Eventually I found comfort from other patients and we collectively formed the Renal Patients Society in 2018. The society is made up of over 200 members, comprising transplant recipients, their donors and dialysis patients. It helps us share our experiences with newly diagnosed patients and those at risk of developing kidney disease, especially diabetes and hypertension patients.

A kidney transplant remains the best medical solution for any form of kidney condition. It may bring a new set of challenges, but these become insignificant when compared to the alternatives. As this area of health continues to grow in the country, more robust laws, allowing and regulating deceased transplants and non-related living transplants, are necessary. This will allow more transplants to be conducted in the country, and it will provide room for research to advance kidney transplant in Kenya.

Article by Elizabeth Mbugua and John Gikonyo (President, Renal Patients Society of Kenya)