Failure to act against renal failure will result in death – Professor Nicholson

Mar 14, 2011 News

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“The consequences of inaction as far as end stage renal failure, dialysis and transplantation are concerned are death, death and more death. That’s not a joke it’s a reality.”
That is the warning from renowned Emeritus Professor of the University of the West Indies, Dr George Nicholson.
According to him, in the absence of haemodialysis and/or renal transplantation, death is predictable, inevitable and relatively unpleasant.
“Without dialysis the lives of five young people suffering from acute reversible renal failure would have been lost in the Georgetown area alone in the last five years,” Professor Nicholson asserted recently.

He explained that effective dialysis performed at a minimum of four hours three times a week can prolong life for as long as 29 years.  According to the Chief Executive Officer of the Caribbean Dialysis Inc. in Barbados, he has seen such effects of dialysis on a firsthand basis.
“That was the experience with my first dialysis patient in Barbados. It is probably a world record but it just shows what can be accomplished. Several of my patients who got on to dialysis after 1980 are already about 15 or 16 years post renal failure.”
Although he resides in Barbados, the Guyanese national has over the years been offering his expertise to the Five G Dialysis Centre in South Ruimveldt, Georgetown.
He will now be offering his support to the Guyana Kidney Foundation which was launched last Wednesday.
Aside from dialysis, Professor Nicholson highlighted that the other line of treatment is that of renal transplantation, which according to him has been conducted in Jamaica for the past 40 years.
This programme has however been brought to a halt due to the immense cost of treatment, since the programme does not benefit from Government funding. He noted though that some Governments of other Caribbean Islands fund dialysis and transplantation to a degree.
“The government of Barbados is beginning to make sounds that it is really distressed about the cost of dialysis. This is a major problem that confronts Caribbean Governments that wish to apply this treatment.”
“Once you open the flood gates, then it is very difficult to say ‘stop, no more’, and then it becomes the question of how do you select who goes on to dialysis? (or) Who gets transplantation with or without Government assistance? These are extremely difficult and very emotive questions to be answered.”
As a result, the rationality for the establishment of a Kidney Foundation stems from a number of realities including the fact that few of those requiring dialysis can afford necessary costs to sustain their treatment, Professor Nicholson noted. He added that there is little merit therefore in advancing a form of treatment that will strain the financial resources of family members or deprive dependent children of an education.
He pointed out that his hope for the advancement of renal replacement theory in the Caribbean rests on three legs, one of which includes the building of a collaborative activity between Caricom States for the provision of expanded transplantation services within the Caribbean as oppose to the duplication of those services in each and every state.
He underscored that since renal transplantation has been performed in Jamaica for a number of years there is therefore a great body of expertise in the technical aspect of transplantation. He highlighted too that the first living related donor kidney transplant in the Caribbean was performed in Barbados in 1980.
It was in 2008 that Guyana was able to offer kidney transplant for the first time at the Georgetown Public Hospital Corporation, a process which was undertaken by Dr Rahul Jindal of the Walter Reed Medical Centre in Washington D.C., United States who had volunteered his service.
The patient was 18-year-old Munesh Mangal, who received a kidney from his mother, Leelkumarie Mangal. The move was regarded as the start of a public/private partnership which saw another transplant operation being undertaken in the following year. The client then was 47-year-old Winston George, an army officer who was forced to retire because of his ailing condition caused by his kidney condition. The donor was his daughter. Two more operations were reportedly done through the collaboration.
However, the public/private partnership has since been halted since according to Chief Executive Officer of the GPHC, Michael Khan, plans are in train to put in place a more concretised system to offer the intricate yet crucial service.
In the meantime though, Dr Jindal has assured that he will continue to offer his service through the Balwant Singh hospital, a private health facility.
In January he was able to screen about six potential candidates for transplant and according to him operations may be possible late April, a process which will be supported by New York based business personality, George Subraj.

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