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Medications and kidney diseases in Ghana

We all take medications for one disease or the other. These medicines are either prescribed or bought over the counter. Prescription may written by a herbal practitioner or an orthodox practitioner. Some clients also buy medications over the counter by themselves. In Ghana, even antibiotics can be bought over the counter, though this is not right. You may have bought yourself some medications for that headache you experienced some few days ago or are still taking some medication for some fever you have.

You may be experiencing that chronic backache or that disturbing knee pain for which you are taking painkillers for. Are you squeezing antibiotics out of your doctor for that viral infection that does not need antibiotics? As a doctor, are you writing medications just to please your patients? It may sometime take you a lot of effort to just explain to a patient that they do not require antibiotics for that cough with running nose but it’s worth it.

Medications are good when well prescribed and well taken. We cannot do without them. However, they can also be harmful when taken in inappropriate doses or when not prescribed by a silenced prescriber. It is good to note that every medication has some side effect both herbal and orthodox. In all cases, side effects of orthodox medications are clearly written in leaflets or in our prescription formulary as doctors.

These should be read by prescribers and patients. There are some medications which are safe when taken for a short period but will be hazardous when taken for longer periods. There are medications that should not be taken together with other medication. It may cause more harm or and be less effective when taken together. I am aware that some patients combine both orthodox and herbal medications for their conditions. As interactions between these are unknown, caution is needed as these combinations may be harmful. Most herbal medication prescribers are silent on the side effects of their medications. Herbal medications also have side effects.  We see these in our hospitals in some cases.

The kidneys are responsible for getting rid of most medication after they are taken. A good kidney function ensures that medications that are taken are cleared from the body without any problems. The most important question to ask is whether your kidneys are functioning at full capacity. This can be determined by how much you are urinating in a day or by simple blood and urine tests.

There are some orthodox medications which are very potent such as painkillers, antibiotics, blood pressure medications, antiviral medications etc. that clinicians are to prescribe with a lot of caution. Such medications should be prescribed with knowledge of the kidney function and regular monitoring of the kidney function is required when these medications are being taken. There might be the need to adjust the dose of some of these medications when the kidney functions are not optimal.

The frequency of dosing are decreased to allow the ailing kidney time to get rid of the medication from the body. Some medications are totally avoided in situations where the kidney functions are affected. Clinician need to be abreast with knowledge of any medications they prescribe and their side effects. Medications can affect your kidneys and cause permanent damage in some cases. It causes more damage when these medications are abused.

Let us be very concerned about our kidneys. It is all we have. The management of kidney failure in the country is very expensive and only few patients can afford. The next medication you take make sure you know whether it affects your kidney or not. Only take as prescribed by a licensed prescriber. Make time to read about medications you are taking.

Report any side affects you notice after you start any medication both herbal and orthodox. Note that herbal medications have side effects also. Make time to check your kidney functions regularly at least once a year. Don’t just be interested in the satisfaction a medication gives you to abuse it. You may enjoy the temporary effect but suffer the side effect immediately or sometime later. Medications can also cause kidney diseases. Prevention is key!

By Dr. Elliot Koranteng Tannor

(Specialist Physician/Nephrologist – Komfo Anokye Teaching hospital)

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