Southern States - Tamil Nadu-Chennai   

They `buy' kidney, and diseases too

By Feroze Ahmed

CHENNAI APRIL 27. When Thirumaal Kandan underwent kidney transplantation five years ago, he thought it would be the end of his woes. But the former State-level boxer now suffers from hernia, liver ailment, tuberculosis in the transplanted kidney, a worn-out right knee, beginning stages of cataract, and is in urgent need of hip replacement.

These are the side effects, direct or indirect, of heavy doses of steroid-based immuno-suppressants he is forced to take so that his body does not reject the acquired kidney.

The medicines weaken or suppress the body's immune system so much that these patients become easily susceptible to diseases. But they cannot avoid the drugs, expensive as they are, as it would mean certain death.

``I would rather be an AIDS victim,'' says the 33-year-old Thirumaal limping and breathless as he walks.

He paid Rs.50,000 for the kidney, and since then has blown away a few lakh rupees on the after-effects of transplantation.

For every report of suffering and exploited donors of kidneys, recipients have a tale to tell, which is as poignant if not worse.

And they come with a moral that transplantation is not the cure for renal failure; it is only a procedure to extend life a few more years.

``In Indian conditions, the post-transplantation survival rate at the end of five years is less than 50 per cent, and almost all suffer from severe medical complications,'' says P. Ravichandran, head of Nephrology and Transplantation, MIOT Hospitals, ruling out any significant respite from post-transplant care.

Besides, post-transplant patients suffer psychosomatic problems, mostly ``because they live in a society which insists they are normal when they clearly are not''.

According to the Kidney Patients' Welfare Association (thi_ka7@yahoo.co.in), a support group founded by Thirumaal and other similar patients, the solution lies in the maxim `Prevention is better than cure'.

Anything from a simple throat infection or sunstroke to hypertension and skin disease or heavy drug dependence could overburden the organ and lead to a kidney attack, says Dr. Ravichandran.

Nephrologists say most kidney failures in India develop from infections or allergic conditions, and can be prevented if identified early.

However, visible symptoms such as swelling of the limbs appear late.

Warning signs to look out for are: patients with high blood pressure waking up in the night to urinate; swelling of the legs; blood in the urine or its foaming; presence of albumin (protein) in urine, especially in pregnant women and diabetic patients; or diabetics developing vision problems which would require laser treatment.

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