Chronic Kidney Disease In Singapore: Why It Is A Silent Killer

Kidneys are organs that perform vital functions and are necessary for life. In this article, we discuss why kidneys are important to our health, what chronic kidney disease is, and why chronic kidney disease in Singapore is a “silent killer” disease.

Kidneys: Functions And Why They Are Vital To Our Lives

We each have two kidneys – located on either side of the body below our rib cage. They perform vital functions including:

• Removing waste and excess fluid.
• Filtering the blood to remove unwanted compounds.
• Controlling red blood cell production.
• Activate vitamin D that regulate bone health.
• Releasing hormones that regulate blood pressure.
• Regulating electrolytes (e.g. sodium, potassium, calcium, magnesium and phosphorus).

What Is Chronic Kidney Disease?

A patient has chronic kidney disease when the kidneys have become damaged over time for a period of at least 3 months, and are unable to function properly. Chronic kidney disease is classified based on cause, and two measurements which can be determined via simple tests:

• Patient’s estimated glomerular filtration rate (eGFR). This is a measure of how well the kidneys are filtering certain agents produced by the body, such as creatinine and cystatin C. A eGFR of less than 60 ml/min/1.73 m is an indicator of kidney disease.
• Urine albumin-creatinine ratio (uACR). Kidneys that function well should prevent albumin from entering the urine. When the uACR is high (≥30 mg/g), it is a sign of elevated albumin levels in the urine. There will be an increased risk of chronic kidney disease progressing to kidney failure.

Besides leading to kidney failure, chronic kidney disease increases the risk of other health conditions such as stroke and heart disease. It typically develops slowly, and doctors classify it into 5 stages to help guide treatment decisions:

Image adapted from Kidney Disease: Improving Global Outcomes CKD Work Group. Kidney Int 2013;3(Suppl. 1):1–150.

Risk Factors For Chronic Kidney Disease

Chronic kidney disease can affect anyone, but some people are at greater risk of the disease Common chronic kidney disease risk factors include:

• Diabetes
• High blood pressure (hypertension)
• Heart disease
• Obesity
• Age (60 and above)
• Family history of kidney disease
• Previous acute kidney injury
• Smoking

Why Chronic Kidney Disease In Singapore Is A Silent Killer Disease

Chronic kidney disease in the early stages is often without symptoms. It is a disease that worsens over time and there is currently no known cure. When detected, steps can be taken to preserve kidney function for as long as possible. The disease, if not managed, can lead to kidney failure. This is when the kidney has lost its ability to function. Kidney failure can have a mortality rate that is as high as some cancers. When the kidneys fail, dialysis or a kidney transplant may be required.

Chronic Kidney Disease In Singapore

Some key statistics about chronic kidney disease in Singapore:

• Chronic kidney disease affects 14% of the population in Singapore. Reference: More people getting kidney failure in Singapore | The Straits Times.
• A study showed that 7 out of 10 Singaporeans were unaware that they have the disease. A likely reason is the asymptomatic early-stage nature of the disease and lack of screening.
• According to the Singapore Renal Registry Annual Report 2022, about 6 people are diagnosed with kidney failure every year.
• The number of new dialysis patients has increased by 50% over 10 years.
• About 2 in 3 dialysis patients have kidney failure as a result of diabetes.
• The 5-year survival for dialysis patients was 56.9%. The median survival was 6 years after initiation of dialysis.
• For transplant patients, the 5-year survival rate is 93.5%.

Chronic Kidney Disease Symptoms And Screening

Learn more about the disease’s symptoms and screening options in this next article.

Undergo Regular Screening Especially If You Have Risk Factors

Regular screening for chronic kidney disease can help to detect chronic kidney disease before it progresses into more advanced stages, making it easier to manage the disease. Especially if you have risk factors, you may consider consulting a renal physician. Dr Wong Weng Kin, a kidney specialist in Singapore at One Future Kidney Care clinic (Mount Elizabeth Hospital), is our Preferred Doctor for renal conditions. Click to learn more about Dr Wong.

Contact us to set up an appointment with Dr Wong Weng Kin.

Learn Why: Chronic Kidney Disease In Singapore Is An Overlooked Danger.