The Alarming Rise of Kidney and Liver Failure Among Young People in South East Nigeria

The Alarming Rise of Kidney and Liver Failure Among Young People in South East Nigeria In recent years, South East Nigeria has witnessed a d...

The Alarming Rise of Kidney and Liver Failure Among Young People in South East Nigeria

In recent years, South East Nigeria has witnessed a disturbing surge in cases of kidney and liver failure, particularly among the younger population. Once considered ailments of the elderly, these conditions are increasingly affecting individuals in their 20s, 30s, and 40s, straining healthcare systems and devastating families. Hospital records and epidemiological studies indicate that chronic kidney disease (CKD) prevalence in the region ranges from 7.8% to 13.4%, with a notable impact on semi-urban and rural communities. Similarly, chronic liver diseases, often linked to viral infections and lifestyle factors, account for 4.3% to 23.3% of cases nationwide, with regional hotspots in the South East contributing significantly. This article explores the prevalence, causes, and potential solutions to this growing health crisis.

Prevalence and the Youth Demographic Shift

South East Nigeria, comprising states like Abia, Anambra, Ebonyi, Enugu, and Imo, faces a high burden of organ failure. For CKD, systematic reviews highlight an overall prevalence of around 11.4% in rural and semi-urban areas, with studies in Enugu and Abia reporting rates of 11.4% and 13.4%, respectively. Alarmingly, the mean age of affected individuals is dropping, with many patients presenting in their early 40s far younger than global averages where CKD typically peaks in older adults. Nationwide data shows kidney failure increasingly hitting young Nigerians aged 20-40, with hospital admissions reflecting late-stage presentations in over 85% of cases.

Liver failure tells a similar story. In Enugu, primary liver cancer and cirrhosis dominate hospital admissions for liver diseases, accounting for 44.3% and 20.4% respectively, with a mean patient age of 46 years. Young adults under 30 in sub-Saharan Africa, including Nigeria, are at risk of hepatitis B-related liver cancer, with inactive chronic hepatitis B showing significant liver damage in up to 44.3% of cases among those aged 18-29. The South East's prevalence of hepatitis B is around 2.1% to 9.8% in various groups, exacerbating liver failure rates.

This youth-centric shift is evident in both organs, with end-stage renal disease now common among 25-45-year-olds, driven by modifiable behaviors and environmental exposures.

Causes of Kidney Failure in the Region

Chronic kidney disease in South East Nigeria often stems from a mix of traditional and modern risk factors. Common etiologies include chronic glomerulonephritis (34.2%), hypertension (23.3%), diabetes mellitus (18.8%), and obstructive nephropathy (10.4%). Among young people, the abuse of over-the-counter painkillers like NSAIDs, unregulated herbal mixtures, alcohol, energy drinks, and recreational drugs plays a major role. Nephrotoxins, including traditional herbs and mercury-containing soaps, are independent risk factors, alongside obesity and family history of renal disease.

Infections such as hepatitis, HIV, and sickle cell disease further contribute, with late presentations leading to urgent dialysis needs in 50% of cases. Environmental factors like contaminated water and food, laden with heavy metals, have been linked to increased CKD risk, though more pronounced in nearby regions like the Niger Delta. Low socioeconomic status and limited access to early screening exacerbate the issue, with over 80% of patients arriving in stage 5 CKD.

Drivers of Liver Failure Among the Young

Liver failure in young South Easterners is predominantly tied to viral hepatitis and lifestyle choices. Hepatitis B virus (HBV) infection affects 49.4% of cases, with hepatitis C at 8.4%, leading to cirrhosis and primary liver cancer. Alcohol consumption, reported in 52.1% of patients, accelerates liver damage, while ingestion of herbs and roots (45.5%) and cigarette smoking (30.1%) are key risk factors.

In young adults, inactive chronic HBV can cause significant necroinflammation and fibrosis, especially with a family history of liver-related death. Non-alcoholic fatty liver disease (NAFLD) is emerging, with a 9-13.5% prevalence linked to obesity and diabetes, though data is scarce. Contaminated foods and synthetic products, including those with toxins, contribute to the rise, as do recreational drugs that damage both liver and kidneys.

Overlapping Factors and Societal Impact

Many causes overlap for kidney and liver failure, amplifying risks in young people. Herbal remedies, alcohol, and drug abuse harm both organs, while infections like hepatitis affect liver primarily but can spill over to kidneys. Recreational drug use, prevalent at 41.9% among youths, correlates with organ damage, with substances like codeine, alcohol, and cannabis cited.

The societal toll is immense: High mortality (32-34% for acute cases), economic productivity loss in the 20-40 age group, and overburdened dialysis centers. In Northeast hotspots like Borno and Yobe, unknown causes account for 18.6% of CKD, hinting at environmental mysteries that may extend southward.

Prevention Strategies and the Path Forward

Addressing this crisis requires multifaceted action. Early screening programs targeting young adults, especially in rural areas, can detect issues before end-stage failure. Public awareness campaigns on avoiding nephrotoxic herbs, moderating alcohol, and vaccinating against hepatitis B are crucial. Regulating over-the-counter drugs and improving water quality to reduce heavy metal exposure will help.

Healthcare infrastructure must expand, with subsidies for dialysis and transplants. Research into unknown causes, particularly in high-burden areas, is essential. By prioritizing prevention and education, South East Nigeria can curb this epidemic and safeguard its youth.

Family writers Press International