KUALA LUMPUR, March 31 — Three years ago, Ahmad Sulaiman was unable to do a lot of activities, let alone go fishing, which was his favourite pastime.

This was because the 63-year-old had been diagnosed with end stage kidney disease (ESKD), which meant he had to undergo haemodialysis treatment three times a week, and monitor his diet and liquid intake.

But Ahmad was one of the lucky ones when his son Mohd Shahrul Ezwan decided that he would donate one of his kidneys to his father. 

Post-operation, both of them are living their lives normally with Ahmad being able to go fishing again.  

How it started 

At first, Ahmad who had high blood pressure and diabetes, was initially diagnosed with stage one kidney failure.

Things began escalating after one of Ahmad’s friends suggested an energy drink and claimed that the drink could help with treating his kidney failure.

A month later, Ahmad’s feet began swelling and he couldn’t get out of bed.

As it turned out, his stage one kidney failure had escalated to stage five due to the drink that he was taking, which contained an excessive amount of steroids.

The energy drink has since been banned in Malaysia.

ESKD is the end result of chronic kidney disease, which is the gradual loss of kidney function over time.

Shahrul said the quickest and most suitable treatment was for his father to get dialysis treatment to rid his body of the waste, extra sodium, and water from his body.

The 35-year-old dental officer from Shah Alam Hospital then said that his father was referred to the Tengku Ampuan Rahimah Hospital in Klang to undergo his peritoneal dialysis treatment.

Peritoneal dialysis is when a special liquid is put in the abdomen and as blood passes through blood vessels in the abdominal cavity, the liquid will absorb the waste across the abdomen’s lining.

The liquid is placed and removed via a catheter and patients can do this treatment at home either manually or with the help of a machine. 

Treatment can be up to four times a day (the duration depends on how fast the liquid is drained out and replaced. It can be as quick as 25 minutes or once a day if one is on the machine (duration is a few hours). 

However, during Ahmad’s first treatment, he suddenly faced difficulties in breathing and the doctors found out that some of the excess liquid from his dialysis had flooded his lungs.

As a result, Ahmad was taken to emergency and had a hole made in his back to drain out the excess liquid from his lungs.

"My father told me that was the worst experience of all.

"He couldn’t breathe and not to mention the pain. They had to puncture a hole in his back and around three litres of water were drained out of him that day,” Shahrul told Malay Mail.

After further inspection by the doctors, Ahmad was amongst the few patients who had a pleuroperitoneal fistula in his abdomen, which is a small window that is linked to his lungs.

The excess dialysis liquid had gone to his lungs through the pleuroperitoneal fistula.

Because of this, Ahmad had to move on to haemodialysis treatment where the blood is cleaned outside the body using a dialysis machine called Dialyser and then sent back into the body.

Ahmad had undergone haemodialysis treatment for about three months and even though his condition improved, Shahrul was still worried about his father’s heart condition as haemodialysis would require the heart to work more to pump the blood.

Life-saving gift

This resulted in Shahrul constantly trying to find the right solution to help his father.

Then one of his colleagues who used to work at the Selayang Hospital nephrology department suggested that his father have a kidney transplant.

Shahrul then researched on the matter by reading articles and even attending a crash course programme about kidney transplant which was organised by a local NGO and the National Kidney Foundation.

Shahrul admitted that it pained him to see his father’s condition especially knowing that they didn’t come from a rich family and his father had worked hard to raise and educate him and his siblings.

After telling his mother about his intentions, Shahrul then presented it to his father who was speechless for a moment before breaking down in tears.

"He told me that he never expected that it would go to this extent, to the point where he had to receive a kidney donation.

"He was trying to say he felt like a burden to his family, but I replied that everything is okay, I’m okay. I spent that time convincing him that there would not be any serious complications from this transplant and I’m absolutely okay with it.

"I also told him that I can still live my life normally with just one kidney. He then accepted it afterwards,” Shahrul said.

Kidney transplant is considered as the best treatment for ESKD by most doctors however the waiting list for kidney donation can take up to years. 

According to a report by New Straits Times in 2021, there are currently around 23,000 patients in Malaysia below the age of 60 who are eligible to be on the kidney transplant’s waiting list; however, only 30 to 50 kidney transplants from deceased donors were performed in a year.

On average, an ESKD patient spends eight to 13 years waiting for an available kidney.

But an ESKD patient can also receive a kidney from a voluntary living donor and in Malaysia, ESKD patients can accept kidney donation from first to third degree relatives like parent, sibling, spouse or even cousin.

Shahrul and his father took about three months to have themselves assessed and tested before proceeding with the transplant.

Three years after their kidney transplant, Shahrul (right) and Ahmad can now participate in normal activities again including sports. — Picture courtesy of Mohd Shahrul Ezwan Ahmad

Now, hiking is possible 

The kidney transplant operation went smoothly for Shahrul and his father although Shahrul had to be readmitted due to a minor infection near his wound.

Shahrul said since their transplant, his father’s blood pressure has stabilised and he’s able to do everyday activities normally again.

However, he still needs to take his high blood pressure and diabetes medication along with some medication for his new kidney to lessen the risk of rejection and inflammation.

Aside from that, his father would also need to eat "clean food” and was advised to avoid unhygienic street food stalls.

Meanwhile for Shahrul, after two months of recovery, life goes on as usual.

The both of them can take part in activities again like sports and Shahrul also shared that after their transplant, he and his father even went hiking together.

Shahrul also said that even though they’re able to do activities again, it was important to do it in moderation just as a safety precaution.

"I hope that from what I’ve shared, at least the public can see that kidney transplant is really the best treatment for kidney failure.

"Because dialysis treatments still have their own complications especially to those with heart problems. For those who are considering kidney transplant, please don’t hesitate to proceed with it.

"At least we get to see the people we love regain their health back,” Shahrul said.