Mystery: 2 boys from same parents developed kidney problem within 6 months

Enoch Odetunde, like his brother, woke up one day in April 2019 with a swollen face and legs that by midday had subsided. His parents could not wave it off because his brother’s case also started like that in November 2018.

Enoch’s parents’ concern was heightened because of Enoch and his brother Gideon continuously experience swelling of their face, legs and arm in their family of six.

“By December, 2018, the swelling had become pronounced and my husband and I started taking them for prayers from one church to another,” said Bose Odetunde, their mother.

Mrs Odetunde who sells building materials added: “At one of the churches, the pastor, seeing the big tummy and the swollen face now affecting their ability to see asked that the children be taken to the hospital.”

She was also worried that only her boys had this problem. Enoch’s case started six months after his brother’s. And because of it, the two brothers had been absent from school for months.

Ironically, the Odetundes are sceptical about the persistent swollen body, including the legs and arms, which initially subsided after two months hospitalisation and treatment at the University College Hospital, Ibadan.

“My husband believed that the problem was spiritual. He said I should take them back to church for more prayers. So, the swollen face, limbs and tummy came back when I stopped bringing them to the hospital for follow up treatment,” she added.

Unfortunately, the severity of the condition made one of the brothers very weak, unable to eat and to retain his medicines due to vomiting.

Mrs Odetunde added, “the day before, I brought him back to the hospital, he fainted twice during prayer vigils.”

The Odetunde brothers were diagnosed with nephrotic syndrome, a kidney problem that requires financial support from philanthropists and well-meaning Nigerians to ensure they are well and can go back to school.

Dr Adebowale Ademola, a kidney disease expert in children, described nephrotic syndrome as a common condition where children leak lots of protein in the urine. So, the level of protein available in the body for use is low.

The body needs protein for a number of things, including drawing fluid from under the skin into the blood vessels and passing out as urine. If the fluid under the skin is retained, the body including the face, abdomen and limbs becomes swollen.

Howbeit, the protein that leaks through the urine over time damages the kidneys and ultimately, the organ stops working.

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Probably that is why the 12-year-old Enoch is stunted in growth. He looks too short for his age. The protein leak has deprived his body adequate protein for body growth and functions.

According to Dr Ademola, “It gets to a stage where the person may require dialysis because the kidneys are not working.”

However, Dr Ademola stated that drugs are available to stop protein getting into the urine and therefore prevent kidney damage and the subsequent need for kidney dialysis.

Howbeit, the first-line medications for treating this kidney problem are not effective in preventing protein from getting into their urine in Africans. They require second-line medication, which is more expensive for treating kidney problem.

“For those second groups of drugs, about 50 per cent will respond to these drugs and end up not requiring kidney dialysis,” Dr Ademola added.

The medical expert, however, said the Odetundes’ case was unique as it started about the same time in the brothers and raised questions about whether it was genetic or related to something they were exposed to in their environment about the same time.

Dr Ademola said “The parents will need financial support to ensure these children can remain on the second line medications that will keep them stable.”

Although the exact cause of nephrotic syndrome or why it starts is still unknown, he said the problem was common in Africans, children with hepatitis B and HIV infection or takes herbal preparations, and are exposed to heavy metals such as lead and mercury.

Currently, the Odetunde brothers are soliciting financial support for their care and it should be sent to the Medical Social office of the University College Hospital.