Health: Hospitals around the country are experiencing a drastic rise in chronic kidney disease (CKD) cases with about 12 people diagnosed every month so far this year.

Dialysis units of the Thimphu, Gelephu and Mongar hospitals recorded 72 new chronic kidney failure cases this year while last year 119 new cases were recorded of which a majority are young people.

Records indicate a steady increase in CKD over the years. From eight cases in 1998, today there are more than 140 cases. About 139 CKD patients are on dialysis at the three hospitals today.

Health officials attribute the rise in CKD to the increasing non-communicable diseases (NCDs) such as diabetes, hypertension, and alcohol liver diseases. Records show that diabetic cases increased to 4,097 in 2012 from 2,541 in 2008, while hypertension cases increased to 27,023 from 20,347 in 2008, and alcohol liver diseases to 2,059 from 1,329 in 2008.

CKD, according to health officials, is the damage of kidneys. The kidneys can’t filter blood like they should and can cause wastes to build up in the body. CKD may lead to kidney failure. When the kidneys fail, a person either needs dialysis or a kidney transplant to maintain health.

A person has two kidneys, each about the size of a fist that filters wastes and excess water out of the blood to produce urine, said health officials. The kidneys maintain the body’s chemical balance, help control blood pressure, and produce hormones.

After a miscarriage about a couple of months back, Tshering, 26, a housewife in Thimphu was in for a bigger surprise last weekend. She was diagnosed with chronic kidney disease (CKD).

Tshering was told that her kidneys had failed as she had hypertension, the same cause for her miscarriage. She had her first dialysis early this week.

Her sister said Tshering didn’t have any other ailment before. “It came as a surprise for the family,” she said, adding Tshering is still traumatised. “Her blood pressure became normal after the miscarriage but it shot again.”

Recently, another 26-year-old woman, Singye was diagnosed with CKD, more than two months after she gave birth to her first child. She has begun dialysis around the same time as Tshering.

Dialysis treatment is a process where the function of a kidney is replicated by a machine. The machine removes body waste by pumping a patient’s blood into the machine, filtering the toxic substances, and sending it back into the body.

The founder and executive director of Bhutan Kidney Foundation Tashi Namgay said that most of the NCDs remain undetected, as people don’t seek immediate health care. “Kidney failure doesn’t happen overnight, it takes place gradually which is why it’s a silent killer.”

As renal failure occurs gradually, Tashi Namgay said symptoms appear only when the kidneys have failed. “The trend is such that young adults in the urban are also suffering from it unlike in the past where it was more prominent in the rural places.”

Tashi Namgay emphasised the need for self health care and early detection centres in rural places. Besides, he said given the increasing number of renal failure cases and its implication to the government, a research should be carried out to get to the root of the issue. “The foundation is working on it,” he said.

Health officials said the increasing CKD cases are a major burden on health, as a majority of the referrals to India comprises kidney failure transplant. If patients find a donor, the government funds the transplant and they are referred to Christian Medical College in Vellore and hospitals in Kolkata, India.

Records with the Thimphu referral hospital show that, from mid 2011 until May last year, 36 patients were referred to Kolkata.  About 20 got kidney transplant from non-related donor, on which the health ministry spent about Nu 9.5M. Another 100 patients were referred to Vellore from 2006 until May last year of which 84 had a transplant.

For every transplant, the health ministry spends about Nu 1.2M to Nu 2.5M.

Kinga Dema

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