Bay woman has been on dialysis longest in SA

IT has been a tough journey for South Africa’s longest-surviving dialysis patient, Port Elizabeth resident Amanda van Wijk. She has had two kidney transplants, more than 20000 hours hooked up to dialysis machines and mountains of medication.

The first patient in the country to receive a kidney transplant at Cape Town’s Tygerberg Hospital – in 1976 – Van Wijk, 56, has been an inspiration to fellow patients suffering from kidney failure and has been vocal on the importance of healthy living. She has been on and off dialysis since 1975.

"It’s a choice you make when you hear you’re in kidney failure,” said Van Wijk, who has to follow a strict diet and ingest no more than 500ml of liquid daily.

"Either you accept it (kidney failure) and get help (dialysis while awaiting a transplant) or you don’t. It doesn’t have to be a death sentence. You might get a kidney, or you might never get one. You make the most of it. There are bad days when you can’t get out of bed. But on those days, I stay in bed and on the good days I live life to the fullest.”

State dialysis treatment is limited to about 100 patients in the entire western half of the Eastern Cape who receive treatment at Livingstone Hospital. Its renal unit has 20 dialysis machines.

The machines take over part of the kidney function, removing impurities from the blood. But patients are also placed on a strict regime of medication, as the machines cannot replace the hormones which healthy kidneys release. Dialysis patients must also pass a strict test – they must have no other chronic diseases, called co-morbidities, while bread-winners are also bumped up the list – and wait on average more than four years for a donor kidney. Even then it is not guaranteed their body will accept the organ.

Van Wijk said while the unit’s staff were efficient, there were too few of them – and more machines were also urgently needed.

DIALYSIS at Livingstone Hospital – which caters for half of the Eastern Cape – costs the state more than R21-million a year for patients’ treatment, medication and dressings.

With 95 patients battling renal failure being treated at the unit in 2008, increasing to 117 last year, the cost does not include the salaries of specially trained nurses and doctors.

A principal renal specialist – one of the top specialties – could earn R800000 a year in government, but double that in the private sector.

Each dialysis machine costs R200000 and each patient costs the state about R15000 a month for their use of the dialysis machines, their dialysis-specific medication and dressings, according to Port Elizabeth Hospital Complex spokesman Nosipho Kota.

"The demand for dialysis has increased by about 7% per year. Furthermore, we have had less kidney donations, which translated in more patients staying longer on dialysis,” said Kota.

"However, we have increased our total number of dialysis patients from 95 at the beginning of 2008 to 117 at the start of 2011 (up 23%).” – Brian Hayward

While cases of kidney failure are increasing because of chronic diseases of lifestyle, like type 2 diabetes and hypertension, Van Wijk’s case is different.

Born with just one kidney which gave in when she was 17, the new kidney she received at Tygerberg Hospital when she was 20 lasted just one year until her body rejected it.

"After that I came home to PE and went back onto dialysis (four hours, three times a week). I had never heard about dialysis until I was confronted with kidney failure.”

The kidney from her second transplant in 1985 lasted five years.

"Doctors say that kidneys donated by family stand a greater chance of being accepted by the body,” she said.