FOR more than 150 kidney patients gathered under canopies in Enugu, and thousands of others across the country, the struggle goes beyond the pain of a failing organ. It is a daily battle to raise the money needed to stay alive. Recently, videos and pictures of some of the patients in Enugu surfaced on social media, drawing.

Recently, videos and pictures of some of the patients in Enugu surfaced on social media, drawing public attention to their plight. Many reportedly arrived in wheelchairs, while others were visibly weakened, with swollen legs, faces and abdomens.

Many of the patients are living with end-stage kidney disease, a stage at which kidney replacement therapy, including dialysis or transplantation, may be required to sustain life. But how many of them can afford the lifesaving treatment? Sadly, kidney disease respects neither age nor social status. Adults and children were among those waiting for assistance to continue treatment.

According to Consultant Nephrologist, Dr Abdulwasiu Busari, about 90 per cent of Nigerian patients discontinue dialysis within one year, largely because of the cost. Their plight puts a human face on Nigeria’s kidney-care crisis, as experts raise concerns about severe kidney disease affecting Nigerians during their productive years, while the cost of treatment leaves many unable to sustain care. The true scale of kidney disease in Nigeria remains difficult to quantify because the country has no current, nationally representative data establishing the overall burden of kidney disease. Available Nigerian studies have produced widely varying prevalence estimates because of differences in populations, locations and diagnostic methods.

A 2025 review reported chronic kidney disease estimates generally ranging from 10 to 19 per cent among adults across studies, while an earlier systematic review found estimates ranging from 2.5 to 26 per cent. These figures should not be interpreted as a definitive national prevalence.

Globally, the World Health Organisation estimates that 674 million people are living with chronic kidney disease, with most affected people in low- and middle-income countries. But behind the statistics are patients whose survival may depend on whether they can raise enough money for their next dialysis session. One of those trying to keep them alive is Emmanuel Onyeka Okoh, popularly known as “Okwulora”, a philanthropist who has been supporting kidney patients in Enugu. In one of the widely circulated videos, Okoh said: “It is sad. Look at them. They are hopeless and helpless and some of them, if they don’t get dialysis, might not even see the next day.”

He said he had sold personal property to support patients and had spent about N15 million at Park Lane Hospital, Enugu, this year alone, to settle bills and help patients continue treatment. A ccording to him, some patients wait for months, and in some cases up to a year, for assistance, while others die because they cannot raise enough money to continue dialysis. H e said his intervention usually covers dialysis for one or two months, after which patients are again left to find money for treatment. “My greatest worry was the number of children in the age bracket of eight to 10 years that have been brought down by kidney problems,” Okoh said. “These children of six to 10 years have not taken alcohol before. They have not smoked before. Yet, their future is hanging and bleak due to this illness.” He said the increasing number of patients needing assistance had become emotionally and financially exhausting. “I’m already tired,” he said, reflecting the enormous burden of trying to keep vulnerable patients on treatment through personal fundraising.

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Kidney disease now attacking productive Nigerians

A Consultant Nephrologist at the Federal Medical Centre, Ebute Metta, Dr Danladi Nmadu, said most Nigerian patients with severe kidney impairment or those receiving dialysis are between 40 and 60 years old. “In most developed countries, kidney disease tends to accumulate in people in their 60s and above, while in Nigeria most patients that we have on dialysis or have severe kidney impairment are between the ages of 40 and 60,” he said. According to Nmadu, the pattern has serious economic consequences because the disease is affecting Nigerians during their productive years. One reason for the late presentation, he said, is that kidney disease can remain silent for a long time. “The kidneys are very resilient organs. They don’t show signs until they are almost completely shut down,” he explained. As a result, many Nigerians only seek medical attention when their kidney function has fallen drastically. “If we catch them early, there are things we can do to stop or slow down the progression such that these patients do not develop kidney failure,” Nmadu said. He blamed poor health-seeking behaviour partly for the late presentation, noting that many Nigerians consider themselves healthy simply because they do not feel sick. “Most young people don’t think they should go to the hospital. A lot of times when they present, it’s too late,” he said.

N150,000 weekly dialysis burden

For those who develop end-stage kidney disease, dialysis can become an unbearable financial burden. Nmadu said dialysis typically costs about N50,000 per session, while many patients require two or three sessions every week. “That means N150,000 every week. Most individuals cannot afford that,” he said. Busari said the financial burden becomes even greater when the additional costs associated with dialysis are taken into account. According to him, apart from the dialysis session itself, patients also have to pay for investigations, erythropoietin and iron treatment, among other services. “The average cost of a single session of haemodialysis now is N50,000. A patient will need two or three sessions per week. But apart from dialysis itself, there are other things that may cost money, such as investigations, erythropoietin and iron treatment,” Busari explained. He estimated that the overall cost could amount to about N600,000 monthly for a patient receiving regular dialysis.

The consequences can be fatal

Nmadu said findings from their practice suggest that more than 70 per cent of patients requiring dialysis die within two years, stressing that inability to afford regular treatment is a major contributor to poor survival. Busari, in a chat with Vanguard, said the financial burden also explains why many patients are unable to remain on dialysis for long.

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