Izah Azahari
Brunei Darussalam is among the countries with the highest rate of end-stage kidney disease, where kidney damage is permanent, with the main causes of kidney disease in the Sultanate are diabetes and high blood pressure.
According to the Brunei Dialysis and Transplant Registration for 2020, there are 881 end-stage kidney patients in total, of which 217 are new cases, leading to an increase of 12.1 per cent over the previous year, while the number of patients who died that year was 138.
This was noted by Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar in his message in conjunction with the World Kidney Day 2022 themed ‘Bridge the Knowledge Gap to Better Kidney Care’. The Minister said that we need to continue to understand that when the kidneys fail to function properly, the patient has only two options; either undergoing dialysis treatment or a kidney transplant. If left untreated, it can lead to death.
“The celebration aims to raise public awareness on the importance of maintaining kidney health and how to reduce the effects of kidney disease as well as health problems associated with this disease,” said the minister.
Earlier on, the minister said kidney disease is categorised as a non-communicable disease. A study by the American Diabetes Association showed that 850 million people worldwide have kidney disease. In fact, the disease is projected to be the fifth leading cause of death by 2040. According to a statement from the International Committee on World Kidney Day 2020, in line with the International Nephrology Organisation, one in 10 people around the world suffers from chronic kidney disease and the number of patients with kidney disease is increasing year by year. This will be a burden to the health care system as patients need lifelong care.
This year’s World Kidney Day celebration theme, said the minister, is ‘Bridge the Knowledge Gap to Better Kidney Care’ which gives the impression that many in the community have low basic awareness, limited health literacy and lack of readiness to know about chronic kidney disease. This knowledge gap restricts the fight against kidney disease and increases the incidence of death among patients. Therefore, the essence of this theme calls on all people of the world to reduce the barriers to gaining knowledge about kidney healthcare and towards better including complex information on kidney disease.
“This year’s theme is also relevant and important during the current COVID-19 pandemic. In general, people with kidney disease have a higher risk of getting worse if they are infected with COVID-19 disease than other patients,” said the minister, adding that this includes those undergoing dialysis treatment and those who have undergone a kidney transplant.
The Ministry of Health through the Department of Renal Services, said the minister, has made various efforts and initiatives towards improving the quality of life of kidney patients and also the people around them with continuing education and patient advocacy, which includes urging kidney patients to get COVID-19 vaccine early during the pandemic, especially for patients undergoing dialysis treatment. “Within two months, more than 70 per cent of the patients had received two doses of COVID-19 vaccine in November 2021. Prior to that, the patients who received two doses of COVID-19 vaccine were less than five per cent,” said the minister, further noting that the initiative is to promote and provide specialised vaccination facilities so that it is easy for the patient to get the vaccine, and provide the appropriate type of vaccination for kidney patients.
The minister said that the Department has also increased the amount of peritoneal dialysis (water wash) for kidney patients, which is the second best and easiest treatment for kidney replacement therapy.
“Treatment through a kidney transplant is the best option but involves many factors that are often difficult to obtain. Haemodialysis (blood washing) is a last resort but has its own risks. One of the barriers preventing patients choosing peritoneal dialysis is feeling fear, anxiety, or lack of confidence towards carrying out their own treatment at home even though it has been explained that they will continue to be guided, counselled, trained and monitored until the patient and family members can do it themselves,” said the minister.
“The misinformation they receive from non-knowledgeable or non-professional people is also one of the factors causing them to choose haemodialysis over peritoneal dialysis. However, Alhamdulillah with the continued co-operation of all patients, there has been an increase in 2021, which is a 40.7 per cent increase in peritoneal dialysis patients from 2020.”
The minister said that improving communication access between kidney patients and nurses according to their respective types of treatment is also being carried out. With the introduction of a hotline, patients and nurses of the Renal Services Department can communicate, including outside office hours, every day if necessary. “This year’s World Kidney Day campaign will focus more on efforts to increase kidney health education and awareness and reduce the high knowledge gap of chronic kidney problems at all levels of kidney care,” said the minister.
He said that this includes initiatives to provide early awareness through counselling to chronic kidney patients and end-stage renal patients on the treatment options available namely haemodialysis, peritoneal dialysis and kidney transplantation; education of kidney patients (including practical advice on diet and lifestyle) to increase the resilience of patients, their caregivers, and their support systems towards achieving meaningful health outcomes and life goals; the integration of chronic kidney problems and the prevention of renal failure into the national non-communicable disease programme for comprehensive and integrated services, which are important in improving early detection and detection of kidney care at the national level; recognition of the rights of patients and caregivers to be able to assess, understand and use health information related to chronic kidney problems; and to offer information related to chronic kidney problems according to various levels of health literacy.
“Alhamdulillah, we are very fortunate in Brunei Darussalam because health services are accessible to all citizens and residents in this country. In addition, various treatments and medicines are given for free when compared to other countries. However, it is our responsibility to work together to adopt a healthy lifestyle, be physically active, avoid tobacco and follow a healthy and balanced diet with effective medicine. The Ministry of Health will continue to strive to provide excellence in the provision of care that is accessible to all, not only in aspects of kidney disease, but in all aspects of non-communicable diseases.”
“With the celebration of World Kidney Day, my hope is to see more people who understand kidney disease, especially patients, caregivers and family members of patients so that all can enjoy a healthy and prosperous life. Let us all increase our role in fighting kidney disease.”
