Why are kidneys in such demand?

[Karol]

Why are kidneys in such demand?

March 18 2011 at 07:16pm
By Omeshnie Naidoo

The cash-for-kidneys scandal, in which prominent medical professionals and the Netcare Hospital Group have appeared in court, has brought to the fore the huge demand in our society for this vital organ.

Durban vascular surgeon Professor John Robbs, Professor Ariff Haffejee, Dr Neil Christopher and Dr Mahadev Naidoo face charges of fraud, conspiracy to commit fraud and contraventions of the Human Tissue Act.

It is alleged that 109 illegal kidney transplants were performed at Netcare’s St Augustine’s Hospital after poor Brazilian donors were paid by Israelis for their kidneys – a trade the operating team said it had not been aware of.

Just why are kidneys so seemingly easy to traffic and in such high demand?

Professor Alain Assounga, head of the nephrology (kidney) unit at Nelson Mandela Medical School, University of KwaZulu-Natal, says: “We all have two kidneys and presumably there is one to spare. Many people do live on one functioning kidney, some with no knowledge the other one is not working or not there.

“Apart from the liver, which can be tricky, it’s the only organ that works like that. You couldn’t do the same with the heart,” he says.

This is what opens up the poor to exploitation.

In an article in the Cape Argus, Dr Elmi Muller, a counsellor at The Transplantation Society (Africa and Middle East), and medical director of the Organ Donor Foundation, says the organ trade took place in South Africa because the country is the continental leader in transplants and “the only country in Africa practising deceased as well as living donation for kidney transplantation”.

“The country leads the way in Africa, especially with its deceased donation programme, now including some of the latest advances like donation after cardiac death and HIV-positive-to-positive transplantation. Like many other developing countries, including India, Pakistan, Egypt, Colombia and the Philippines, South Africa was targeted as a destination for organ trafficking in the first few years of the past decade.”

Muller believes strict regulations now in place will clamp down on the exploitation of poor foreigners. However, despite this technological prowess and the “kidney to spare” perception, there is still a shortage in South Africa.

At present there are about 400 people on KwaZulu-Natal’s transplant list, says Assounga.

“A patient can wait for anything between three to five years for a kidney transplant, sometimes dying on dialysis.”

There are several transplant centres in South Africa for kidneys, he says, so lists are provincial, “although, if a kidney is not used in a particular province, it can be sent elsewhere”.

Assounga says the root of the dilemma is in society’s beliefs about organ donation. “Here, even if a patient is brain dead or dies, the family does not want to donate organs. This can create a terrible cycle as the people who need them can become desperate and perhaps seek illegal means to acquire them.”

Keeping your kidneys healthy

Stop smoking

If you don’t smoke, don’t start. If you do, quit. People who smoke are three times more likely to have reduced kidney function, and have a four to five times greater risk of heart attack and stroke.

Limit Alcohol

Excessive alcohol intake can lead to heart disease and high blood pressure, increasing the risk of kidney disease. Limit alcohol to two standard drinks a day for men, and one a day for women.

Nutrition

The food you eat plays a huge role in the health and well-being of your body.

People who are overweight are at an increased risk of developing diabetes and high blood pressure, major risk factors in kidney disease. In fact, losing as little as 5kg reduces blood pressure in most people who are 10 percent over their ideal weight.

Water

Make water your tipple of choice. Water assists in transporting nutrients around the body, as well as helping to eliminate waste. Limit your intake of caffeine and cola.

Exercise

The benefits of regular exercise are wide-reaching. Not only does it help to maintain and reduce weight, it can also reduce the risk of heart disease and diabetes, risk factors for kidney disease. - The Mercury

* Additional sources include:

kidney.niddk.nih.gov/Kudiseases/pubs/yourkidneys/;

www.nkf.co.za;

www.vital.co.za