My brother-In-law's kidney gave me a second chance

On March 14, 2025, as Kyarie Mwangi was wheeled into the operating room, the world around him slowed down for a single moment. The bright hospital lights above him symbolized the light at the end of the tunnel after years of pain.

He was not scared but grateful, because somewhere in that same hospital, his brother-in-law was preparing to give a piece of himself so he could live, and the thought alone filled his heart with gratitude and deep emotions.

“How do you thank someone who literally gave you a second chance,” Kyarie says his voice filled with undecipherable emotions.

In 2022, Kyarie was informed that he had suffered kidney failure. He had managed diabetes for years. He would later be diagnosed with hypertension then later kidney failure.

“It was a hard time. I went for dialysis for around three years, twice a week, it distorts your life.  The problem was also finding a kidney donor, I tried with family members and relatives but due to underlying issues they were not good matches,” he says

He did not go for short calls for three years.

“You pee through those pipes. The dialysis machine cleans the blood. So, it takes out the water out of your system plus the dirt, but it’s not like totally efficient. It’s just a machine. So, it will do, half the work and then the rest of the dirt is in your system,” says Kyarie

After a while Kyarie thought there was light at the end of the tunnel when his then wife decided to donate her kidney. However, the light turned out to be from an oncoming train crushing all his hopes when the final tests revealed that the she was not a match.

The transplant was to be done at Kenyatta National Hospital but the compatibility tests were done at a private facility.

“There was a blood mismatch, but it just happened that we found out when we had done all the other tests, which had cost around Sh350,000. The blood match should have been the first test done but this facility was just after money,” he says. 

Finally, his brother in-law (his sister’s husband) offered to be a donor. Several tests were done and he was a match.

However, there was another challenge. Kenyatta National and Referral Hospital (KNH) does not do kidney transplants if the donor is a non-relative. So, they had to look for funds and go to a private hospital.

“We were advised to go to MP SHAH hospital. They were really nice guys, they walked with us through the whole process. It was a smooth experience,” Kyarie recalls.

He says that he was prepared psychologically by a counsellor. He advocates for as strong support system.

The surgery took around four hours. Thereafter, he was put in High Dependency Unit (HDU), where he was monitored 24 hours for three days.

“After that I was taken to a private ward, it was cosy, good food. It was like a hotel,” he adds laughing. ”I was discharged after four days.”

His energy came back almost immediately his skin complexion went back to its original form. One of the things he says he had “forgotten” was urinating. After three years of dialysis and not urinating normally it became foreign to him.

“It’s something that you totally forget. It’s interesting now in the middle of the night waking up to go pee. The things you take for granted,” says Kyarie

 Challenges

Apart from having a new kidney, Kyarie adds that now he has to be on medication for the rest of his life to prevent rejection of the new kidney.

“Right now, I spend between Sh12,000 and Sh16,000 a month. But it’s different for everyone. For the first six months after surgery, one can spend between Sh42,000 and Sh50,000. But with Social Health Authority cover, it can be cheaper,” he says

During his dialysis journey, he was advised to go for prayers, or unverified herbal medication instead of treatment.

About his brother-in-law, who donated the kidney, Kyarie says “I have no words, I am extremely grateful.”

Ready for the transplant

But the donor does not see himself as a hero. Even during the interview, he requested for his name and photos not to be used because he feels any human being should be able to help where they can.

“There are times you just need someone to help you, and you get that help, so when it’s your turn to help, just do it,” he says.

After getting a donor proved difficult For Kyarie, he told his wife (Kyrie’s sister) he would like to be a donor. She was reluctant at first, before eventually coming on board. Then they informed the rest of the family.

After going through the testing and everything was approved, they were ready for the transplant. The donor was discharged on the fourth day after the surgery.

About the whole experience he adds: “It’s not something that was imposed on me, nobody was even looking at my direction. There was a need, I could help, so why not,” he says.

Kidney transplant process

Dr Hussein Bagha, OGW Consultant Physician and Nephrologist M.P Shah Hospital, says the main causes of kidney disease are diabetes and hypertension. Obesity is also becoming more prevalent.

A lot of patients don’t know that they’re living with chronic kidney disease because the initial stages don’t have symptoms.

“What happens is sometimes it is discovered coincidentally when they’re going for a health check ups and when they come to us, it’s already in stage 4/stage 5 chronic kidney disease,” says Dr. Bagha

“There are five stages of kidney disease. In layman’s terms, the staging is based on your kidney function. However, clinically it’s called estimated glomerular filtration rate or EGFR. Stage five is EGFR is less than 15 mils per minute,” says Dr. Bagha

When does a patient require dialysis?

Dialysis normally is when you reach end stage kidney disease. However, Dr. Bagha says there’s no one particular number for your EGFR.

“We have to take everything else into account. Sometimes a patient can be fluid overloaded; there’s a lot of fluid in the body causing difficulty in breathing and not producing any urine at all. So that patient may require dialysis even if they have not reached EGFR of less than 10,”

He adds that sometimes potassium may be extremely high and despite medical therapy, it is not coming down. That patient may need dialysis to reduce the potassium because it can cause fatal arrhythmia.

An arrhythmia is an abnormal heart rhythm where the heart beats too fast, too slow or irregularly due to faulty electrical signals.

Dr. Bagha says the biggest challenge is finances.

“SHA does not cover the full package of a kidney transplant. It only gives like a quarter of what is required. The second challenge is for the medications post kidney transplant. SHA is trying to cover for that, but you see, it is intermittent because sometimes the drugs go missing and the patients have to buy out of pocket. So, the drugs easily cost between 300 to 400 US dollars (Sh39,000 to Sh51,600) per month.”

Why transplant when dialysis is “cheaper”?

“Alot of patients ask me if I’m paying Sh500  for dialysis per month, which I’m assured of, why should I pay $400 for drugs monthly? So they would rather stay on dialysis because they can raise the Sh2 million for the transplant through fundraisers but after that, what happens? As medical doctors, we cannot transplant a kidney then the patient loses it because of lack of drugs, because when you don’t take your medication, then your body starts rejecting the new kidney,” he says

Dr. Bagha says the government can save a lot of money if they also invested on post-transplant drugs.

“One patient’s dialysis costs Sh10,600, for eight sessions that is Sh84,800 per month. When you’re doing a kidney transplant and SHA covers it, after three years, you actually start saving money as a government per patient. So even if you don’t pay for the transplant, but if you just pay for the transplant medication, the transplant medication costs roughly around Sh40,000. Now paying Sh40,000 per month versus paying 84,800 per month, which is cheaper?”

Nephrology nurse

Julius Maingi, a nephrology nurse, provides specialised care for patients with kidney failure. when kidneys fail, patients require renal replacement therapy because the kidneys can no longer remove waste and excess fluids from the body. There are three main treatment options: dialysis, peritoneal dialysis, and kidney transplant.

Haemodialysis involves taking blood from the patient and passing it through a machine that acts as an artificial kidney. The machine filters toxins and excess water before returning the cleaned blood to the body.

Peritoneal dialysis, on the other hand, uses the patient’s peritoneal membrane inside the abdomen.

“A catheter is inserted into the abdomen, and a special fluid called dialysate is introduced. The fluid stays in the abdomen for about two hours, allowing waste products and excess fluids to pass through the membrane before the fluid is drained,” Maingi explains.

Kidney failure progresses gradually through five stages. Some patients may still produce small amounts of urine due to residual kidney function, while others may not. Patients on dialysis often need treatment two or three times a week. Challenges include infection risks, financial costs, and major lifestyle adjustments.

Dialysis does not cure kidney failure but helps sustain life while patients prepare for or await a kidney transplant.

Transplant Coordinator

Mary Wahu Kagai, a nurse and renal transplant coordinator at MP Shah, says her role involves guiding kidney transplant patients and their donors through every stage of the transplant journey, from the initial consultation and testing process to surgery and long-term follow-up care.

When a patient arrives with a potential donor, the first step is education on the full process. It includes medical tests, consultations, surgery, and recovery period.

“After this, the patient meets a nephrologist who performs a physical examination and begins the pre-transplant workup: basic laboratory tests to check how the body’s organs are functioning, comprehensive tests such as tissue typing and compatibility testing between the donor and the recipient,” Kagai explains.

Patients and donors also undergo radiological tests, including CT scans, ultrasounds, chest X-rays, and specialized kidney scans to assess the structure and function of the kidneys.

A second nephrologist reviews the entire case to avoid medical bias and ensure that all hospital protocols are followed. The case is then presented to an ethics committee that confirms the transplant meets legal and ethical standards.

“After surgery, I coordinate recovery and long-term follow-up, ensuring patients take their immunosuppressant medication correctly, maintain hygiene, attend clinic visits, and successfully reintegrate into daily life,” she adds.