Managing kidney disease

by P.V.D. Leo Samson

The recent story of a young female who died due to the non availability of a kidney donor in Sri Lanka compels us to focus on the issue of the management of kidney disease in Sri Lanka.

The young woman got her famous singer to play the song she loved prior to her death. While we need to appreciate the freedom of the press to discuss the kidney transplant business involving Indian citizens in Sri Lanka, it is equally important to address the issue of kidney patients in Sri Lanka.

The government has taken many remedial measures to provide relief to 1500 kidney patients who need dialysis. There was a news report that Prime Minister Ranil Wickremesinghe requested the Dutch Prime Minister to provide assistance to provide relief to kidney patients in Sri Lanka. While these laudable efforts continue, it is also important that institutes involved in fundamental research gets involved actively in genetic research on kidney disease.

The research in genetics need to study and identify genetic correlations with kidney affected patients.

This type of research is common in advanced economies such as the United States.

They research as to whether any particular ethnic group is more vulnerable to identified non communicable diseases.

Vulnerable

It is not known why rural farmers in certain provinces are more vulnerable to kidney disease than others. It is hypothesised that continued exposure to certain types of chemicals in fertiliser causes this disease.

But the same fertiliser is used in other areas of the country where the incidence of kidney disease is not as high. It is assured that soil composition in the intervening areas is variable.

Sri Lanka needs a specific theory, with an acceptable level of confidence on the factors that lead to kidney disease.

Challenge

This is a challenge to scientists on fundamental medical research who can examine the vulnerability of DNA strands to physical environmental factor such as chemicals, soil conditions to kidney affliction.

It is known that research needs resources-financial, material and human to conduct fundamental research and hours of their dedicated work in laboratories do not attract the attention of the media and politicians.

Neither are they interested in such attention. It is not that researchers only need to focus in such areas of interest. Sri Lanka needs to embark on fundamental research based on genetics.

The hypotheses need to be framed whether any particular ethnic or geographical community whose DNA strands react to chemicals used in fertiliser or soil conditions or whether water consumed affects them differently.

These are research questions that fundamental researchers need to formulate. The Ministry of Health can search for them and provide necessary resources.

Ongoing research

There may be ongoing research in this area already but such important research should be part of a national effort and not merely work done in laboratories alone.

If there is a difficulty to allocate resources, there are several endowments which can be approached for funding for substantial research effort. The media can play an important role in this effort.