Renal failure crisis amid rising lifestyle diseases

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arbados is grappling with a mounting kidney failure crisis, with over 400 patients now living on dialysis, as health experts warned that soaring rates of hypertension, diabetes, and obesity are driving the surge in end-stage renal disease, a top medic warned on Monday.

Dr Margaret O’Shea, transplant surgeon at the Queen Elizabeth Hospital (QEH) and lecturer in surgery at the University of the West Indies, highlighted the alarming rise in non-communicable diseases (NCDs) as a key factor behind the growing number of patients suffering from kidney failure.

“The numbers of patients ending up with renal disease is going up and up, and hence the numbers ending up with end-stage renal disease is increasing year on year,” she told the hospital’s Pulse Radio Show.

Dr O’Shea revealed that dialysis now consumes 12 per cent of the QEH’s budget. While acknowledging that this cost is unsustainable, she stressed that kidney transplants could significantly reduce expenses.

“The expense for donation and then probably the add-ons, which would be medication after having the kidney, compared to years and years on dialysis, is substantially lower,” she explained.

“The upfront cost for a transplant is about $50 000 for the first year, and that drops to about $20 000 annually after that. Meanwhile, dialysis costs about $60 000 to $70 000 per patient per year. So, you can see the savings—about $20 000, $30 000, even $40 000 per patient annually.”

But Dr O’Shea admitted that a lack of donors remains a significant obstacle to increasing transplant numbers.

“The big challenge is you need somebody to give you the kidney, and a lot of times you have patients who don’t want to ask, or nobody’s offering,” she said.

“It’s a big ask, but I would emphasise that the donation process is safe for the donor, and we do full investigations to make sure they are healthy before moving forward with surgery.”

Since 2015, Barbados has performed 16 kidney transplants with a 100 per cent donor survival rate. Yet Dr O’Shea stressed that without more living donors, the country must establish a deceased donor programme to meet rising demand.

“In other countries where they have the legislation, there’s something called deceased donation,” she explained. “Patients who have had a sudden tragedy and are declared brain dead—which is in fact dead because there is no chance of recovery—can become donors. That would allow us to help far more people without the stress of finding a living donor.”

Dr O’Shea noted that legislation for a deceased donor programme is already before Parliament but emphasised that public awareness campaigns will be critical to changing perceptions about organ donation.

“In countries like Spain, they invest heavily in marketing and public awareness. It’s in the schools, on the radio; there’s constant public relations. We need to do the same here,” she said.

If implemented effectively, such a programme could more than double annual transplant numbers in Barbados while easing pressure on QEH’s dialysis services and saving millions in healthcare costs.

“The more we do, the more positive outcomes people see, the more donors will come forward.

“This is not just about reducing hospital costs—being able to free yourself from dialysis is a huge change, and studies show that patients live longer and enjoy a better quality of life after receiving a new kidney.” 
shannamoore@barbadostoday.bb