The Malaysian Insight

KIDNEY disease, an illness that can be brought under control by lifestyle changes at the onset, costs Putrajaya a RM1.6 billion annually.

Treatment for a patient with kidney failure costs RM40,000 a year, and with some 40,000 patients seeking treatment for kidney failure last year, the government is feeling the weight of the burden to treat a disease that doctors say can be managed with early treatment and care.

Patients also realise this, much to their regret, and they struggle to regain a semblance of normal life amid loss of work and lifestyle adjustments.

Patients with chronic kidney disease who require dialysis at least three times a week find it the hardest to adapt. 

Mohamad Kamarulzaman Akasha, 40, who was diagnosed with kidney disease two months ago, is finding it hard to cope, not only with his illness, but to the pressure of having to provide for the family.

Though he has a year left on his contract as an oil rig piping designer, his company is already asking him when he plans to leave.

The father of seven has decided to sell his house to meet family expenses as well as to pay for his dialysis treatments.

“I’m in the process of selling my house to move to Sepang where I have some land. The money from the house support the children’s needs for a while.

“I’ve also thought of withdrawing from my Employees Provident Fund (EPF). That’s how it is when you are sick,” he told The Malaysian Insight at Sungai Buloh Hospital in Selangor.

His monthly commitments exceed RM7,000, with two children at boarding school and his wife a full-time homemaker.

Kamarulzaman admitted that his kidney problems stemmed from unhealthy eating habits and work stress, which had also given him hypertension.

He said he regretted ignoring his doctor’s instructions and failing to regularly take his prescribed medicines.

“I was busy with work. I didn’t care what I ate. I always ate out. So all the food I consumed was high in cholesterol and salt. Taking my medication irregularly also caused my blood pressure to spike.

“Work stress is one of the causes. When you are contract-based, you always have a fear of losing the job.

“Ironically, everything that I’d feared is happening now. I have high blood pressure and both my kidneys have failed.” 

Deputy Health Minister Dr Hilmi Yahaya in October said around 40,000 people last year had sought treatment for kidney failure, while 3.5 million Malaysians were diagnosed with diabetes.

He said the RM1.6 billion spent on treatment was a “huge burden” for a “disease that can be controlled in its early stages”.

Muhammad Nohi Omar, 45, who has suffered diabetes for almost a decade, said he failed to take his doctor’s advice to control his sugar intake.

“I love to eat sweet things. That was before I had diabetes. But now it’s too late. I have to be strong to do dialysis if I want to get on with life,” said the father of two from Saujana Utama in Sungai Buloh.

Like Kamarulzaman, the disease also put Nohi out of work.

“There are side effects after dialysis. You will always have joint pains and fatigue. So, after a few years, I applied for a mutual separation scheme from the company.”

Nohi, who worked for nearly 20 years at Amanah Ikhtiar Raya, said his Social Security Organisation (Socso) pension, which equalled 65% of his previous salary, had been critical in helping to pay for the family’s needs and his treatment.

Sungai Buloh Hospital internal medicine specialist Dr Jeevita Supayah said kidney patients faced drastic lifestyle changes at the onset of the disease.

The hospital helps by charging only RM13 for a dialysis session.

“We never turn a patient down. Dialysis treatment is the one hope they have to live. If they need a medical report for treatment at other dialysis centres, we will also prepare it for them,” she said, referring to dialysis centres run by the National Kidney Foundation, Socso and zakat centres.

Patients are also given counselling to cope with the illness.

“They need support to manage a change in lifestyle. The hospital lends support with professional counsellors as well as counsellors who are patients themselves, and nutritionists for advice on diet,” Dr Jeevita said.

Patient Siti Hazwani Ramli, 30, who receives dialysis at a private healthcare provider with the help of Socso payouts, said it was hard to accept the consequences of her disease and the lifestyle changes it entailed.

Her work as a human resource assistant in a private company is affected because of the hours she spent receiving dialysis treatment.

“While I am fortunate that I get help from Socso and moral and financial support from my company, the treatment causes delays and slows down my work output.

“I’ve had this sickness for three years. It is hard to take holidays and spend time with family. What’s worse, I’m a pregnancy-risk.” – January 1, 2018.