When I hear a Nat King Cole song or a duet by Natalie Cole with her late great father, I think of summer afternoons driving down Ocean Parkway, heading to Coney Island with my Dad and sisters.

Natalie Cole was a great singer in her own right, and recently passed away from Idiopathic Pulmonary Arterial Hypertension, which was undoubtedly a complication of kidney disease, subsequent to treatment for Hepatitis C – which she suffered from for over 2 decades of her life.

According to this article Natalie Cole  had undergone chemotherapeutic treatment for Hepatitis C that lead to her development of Kidney Failure in just a matter of months. Subsequently she was on hemodialysis until she received a kidney transplant in 2009. She contracted Hepatitis C from intravenous drug use, to which she has admitted to.

Pulmonary hypertension is associated with receiving hemodialysis and kidney transplantation. There is a 5 – 14% prevalence of Pulmonary Hypertension associated with renal transplant, and the prevalence with hemodialysis is as high as approximately 50%. Signs and symptoms of Pulmonary hypertension are often masked, and diagnosis may only be confirmed after right ventricular  heart failure develops. The condition is a progressive disorder, that increases both morbidity (sickness) and mortality (death). Irreversible heart failure ensues followed by death.

Hepatitis C

Hepatitis is the term for liver Inflammation. Hepatitis can be caused by many pathogens, but the main cause is viral hepatitis. There are 5 types of viral hepatitis of which Hepatitis C is one.

Hepatitis C was first characterized as non-A-non-B-hepatatis. Discovered in 1989, after an outbreak of chronic hepatitis in transfusion recipients in the 1970’s, the RNA virus causes an infectious disease that affects only humans and chimpanzees.

Hepatitis C is spread  directly from person-to person, primarily through intravenous drug use or unprotected sex (usually anal sex). It is spread through the blood and through circulation infects the Liver; where it enters the hepatocyte (liver cells) and replicates more of the virus. Therefore, It can also be contracted during blood transfusion, organ transplantation, and dialysis (if contamination is present). Tattooing and piercing are also a risk.

Once contracted the virus causes acute hepatitis which might spontaneously resolve on its own. In those whom fail to clear the virus on their own, chronic hepatitis ensues. The disease is often asymptomatic, and therefore many who are infected are unaware. Clinical manifestations present as jaundice, enlarged liver, and anorexia. The disease eventually may progress to Liver Cirrhosis and/or Liver Cancer, this often occurs within 10 to 20 years of having the disease.  Unlike Hepatitis B, there is no inoculation vaccine available against Hepatitis C.

Despite of all this, Natalie Cole continued to sing, tour, and lead a productive life. She never gave in, and or that she will always be “Unforgettable…that’s what you are…and forevermore that’s how you’ll stay”. RIP Natalie Cole.