Living With 4 Kidneys In Africa

Few days ago, UK media published the story of a lady that went to the hospital complaining of pains due to a previous diagnosis of urine infection but was later discovered to have four kidneys. This is quite a deviation from the popular stories of patients on the renal wards of hospitals who are having failing kidneys and in dire need of renal transplants. But with the existence of this category of individuals with multiple kidneys, many believe it will help save lives of many patients whose chances of survival rely on the hard-to-come-by good Samaritan that will willingly give away a kidney.

While there are many people with extra kidneys in the world, a large number are not aware of the additional renal organs and those that are aware often do so when they had to do ultrasound scan or undergo surgery for a life threatening condition. However, the condition presents the affected patients with imminent health issues arising from the deviation from the normal size of the kidney.

Niaz Ahmad, a transplant surgeon noted that while many people in the developed world have been discovered to have extra kidneys, a large number of the extra kidneys are poorly formed.

"It's extremely rare for additional kidneys to be complete. One in a million is probably about right," he said.

In populations studied, the proportion of people with extra kidneys is about 1 per cent and it is caused by an error at the first trimester. At this stage, the baby's two kidneys that are undergoing development split in two. It is more common for these "duplex kidneys" to split only partially, or to grow a second ureter (the tube that drains urine into the bladder).

When adequate tests are carried out and all the kidneys are certified viable, the owner of the four kidneys can donate to patients in need of renal transplant. 

In Nigeria and other African countries, little is known about people with 4 (or more kidneys), this is not unconnected with the poor quality of diagnostic health services on the continent. Furthermore, the various African cultures have different explanations for medical aberrations.

Despite these and several other challenges militating against early diagnosis of individuals with more than enough kidneys, the continent remains the part of the world where the citizens are still not entirely well enlightened on organ donation. But with adequate screening of people presenting with urinary pains for the presence of multiple organs, the renal wards may find a steady supply for kidneys for transplant.

An ethical issue may now arise, which is - who has the supreme authority over the extra organs?

In a well enlightened society, an individual could be informed enough to take decisions but in Africa where many are still scared of going under the surgeon's knife for life threatening conditions, few will freely accept to go through surgery to remove the extra kidneys for organ donation.

In the light of these matters arising, African states need to promulgate laws and publish standard protocols that will address the gray areas in organ donation. Because while many are skeptical about giving one out of two kidneys to someone in need, those with more than enough will readily give to those whose lives depend on such donation if they are sure of the safety of their lives and ethos of such organ donation.