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It is well known that Jamaica has a high incidence of diabetes mellitus and hypertension. What remains unfortunately less well known is that if untreated or inadequately treated both of these conditions may lead to permanent kidney damage, thus producing the entity known as chronic renal failure which if untreated always leads to death. The estimated crude point prevalence of chronic renal failure in persons 20 years and over at the end of 1999 was 327 per million population, it likely that this is highly underestimated.
Other causes of irreversible kidney damage include long standing inflammation of the kidney (chronic glomerulonephritis), longstanding infection (Chronic pyelonephritis), systemic lupus erythematosus, sickle cell disease, longstanding obstruction the urinary tract (e.g. Enlargement of the prostate) and this is by no means and exhaustive list.
The kidney performs several vital functions; most importantly it filters the blood removing impurities and toxins which are almost always waste products of various metabolic processes involved in maintaining life. During the process of cleaning the blood it removes excess fluids in order to maintain the correct volume of blood within the circulatory system. The combination of the fluid and toxins removed gives rise to urine. Therefore the human being must produce a minimum amount of urine per day, according to this process in order to maintain normal function of all the organs. The kidney also produces a hormone which is responsible for stimulating the bone marrow to produce the chief component of blood the red blood cells and which helps to prevent the blood count being low. The balance of electrolytes such as calcium, phosphorous, acids and bases are also dependent to some extent on the kidney.
Failure of the kidney therefore results in death unless adequately treated with one of the forms of RENAL REPLACEMENT THERAPY such as Transplantation, Hemodialysis and Peritoneal Dialysis.
In my capacity as a nephrologist working both in the public and private health sector in Jamaica it quickly came to my attention that there was a shortage of reliable information about what types of dialysis is offered where and how in Jamaica. Patients would frequently end up calling through the public hospital switch boards at Spanish Town Hospital in St Catherine because they were visiting Jamaica and needed dialysis in Mandeville or Ocho Rios. This suggested to me that a common resource was necessary to aid in the booking of dialysis for visiting patients many of which are paying their own way without insurance and for whom value for money and time were both incredibly important commodities.