From Jonah Lomu to a forgotten community: Shedding light on the reality of kidney disease in NZ.

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Jonah Lomu was arguably New Zealand’s highest profile kidney patient in recent memory. Jonah’s time with chronic kidney disease was, as the saying goes, ‘a game of two halves. Incredibly, he was still able to score tries and terrorise opposition defenses while undergoing significant treatment for his condition. Unfortunately, the ‘second half’ of Jonah’s journey involved dialysis, a kidney transplant & ultimately a much-shortened lifespan which is all too familiar for most in this situation. 

World Kidney Day, which takes place on Thursday 9 March, offers an important chance to raise awareness about kidney disease, share the experiences of those affected by this serious condition, and explore ways to enhance support and prevent further cases. And, with kidney transplants being an indisputable win-win for both patients and taxpayers, it’s also an opportunity to ask why our rates of transplants in New Zealand are well below where they should be?

Ask around and you might be surprised at how little people know about their kidneys. These two fist size organs work nonstop to cleanse our blood of toxins and help eliminate waste from the body. Kidney disease is generally marked by a gradual decline in function, however, if your kidneys stopped working on a Monday, you’d be lucky to make it to the end of the week.

As the most famous kidney patient in New Zealand, Jonah Lomu brought much-needed attention to this condition. However, kidney patients today often are something of a forgotten community. This is mainly due to the significant amount of time they spend receiving treatment, such as dialysis, which can take over 20 hours per week. In addition, many kidney patients have complex medical and social needs, including housing and employment, which can result in their exclusion from mainstream work and social settings. To address these issues and give kidney patients a voice, organisations such as The Kidney Society play a crucial role.

Generally, the most effective way of dealing with a dying kidney is to replace it. There are close to 500 people deemed suitable to be on the transplant waiting list but only around 200 transplants a year in New Zealand which is low by comparison to other countries. There are strong medical and economic benefits in transplantation. 

A report from 2019 by the NZIER concluded that transplants present a golden opportunity for health system savings and better outcomes. This report projected a benefit of $500,000 per transplant over a 20-year period and argued that increasing the rate of renal transplantation should be a national priority. Kidneys aren’t an off the shelf item and recipients have to be carefully matched with either a deceased donor or a generous live donor, unfortunately these are in short supply.  Kidney Society and other advocacy groups are concerned that Government has not fully implemented its 2017 National Transplant Strategy, in particular when it comes to equity issues for Māori and Pacific. Unhelpful myths abound that transplantation clashes with traditional values in these cultures.  

As with so many different chronic conditions, the incidence of kidney disease is very much on the rise with the economically and socially disadvantaged sections of our population being disproportionately affected. Māori and Pacific populations account for 60% of the 3000 people receiving dialysis treatment which costs over $100,000 per patient per year. 

Predictions suggest that overall dialysis numbers will increase by 30% in the next decade. All this has a depressingly familiar ring to it. Progressive kidney disease can be slowed and, in many cases, prevented. NZ’s rates of obesity and its related diseases should be considered akin to a national scandal. The associated health crisis isn’t ‘looming’ anymore, it is hiding in plain sight at Middlemore Hospital and similar facilities across the country. 

When it comes to disease prevention, it is our politicians rather than health professionals who need to step up and change the landscape. We all want our society to be in better health but the mahi is complex and just like successful tobacco control initiatives it involves game changing strategies. In the future, will today’s junk food sponsorship of sport be seen in the same light as cigarette sponsorship from years gone by? 

One shameful international ranking relates to NZ’s place close to the top of the OECD obesity charts. This election year, it is important to pay attention to candidates who prioritize health promotion strategies and aim to make our country a healthier place. While such candidates may be scarce, their voices and ideas are valuable and deserve to be heard. 

We must work together to address this issue and take meaningful steps towards a healthier future for all.