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.
Chronic Kidney Disease Singapore Statistics
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.
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 Symptoms
Chronic kidney disease often does not present symptoms until the advanced stages. However, when symptoms do present, they may include:
- Foamy urine.
- Puffiness around the eyes, or swollen feet and ankles
- More frequent urination, especially at night
- Fatigue
- Concentration difficulty.
- Poor appetite or nausea.
- Sleeping difficulties and nighttime muscle cramps.
- Dry or itchy skin.
Screening & Prevention
The following actions may help to prevent or delay chronic kidney disease:
- Lose weight if you have obesity.
- Engage in physical activity to help control blood sugar levels.
- Quit smoking.
- Keep your cholesterol levels healthy.
- Reduce salt intake.
- Consume more fruits and vegetables.
- Limit alcohol intake.
Checking for chronic kidney disease in Singapore can easily be done as part of an overall annual health screening, or can be done by itself. There are two tests needed to determine kidney health: A blood test to determine the estimated glomerular filtration rate (eGFR), and a urine test to determine the urine albumin-creatinine ratio (uACR).
Learn more about the disease’s screening options in this next article.
Chronic Kidney Failure Treatments
There is currently no cure for chronic kidney disease. As such, treatment is instead focused on managing the conditions that are most likely causing the chronic kidney disease, slowing slow down the progression of the disease, lowering the risk of cardiovascular disease, or treating complications. Treatments may include various types of medications to control and dietary changes.
Learn More: Chronic Kidney Disease Treatments And Guide To Finding A Kidney Specialist >>
Costs
Cost Of Chronic Kidney Disease Screening
Renal profile screening packages in Singapore typically cost under S$100, excluding the doctor’s consultation fees. The more costly packages will include a more comprehensive suite of tests. In addition, a kidney ultrasound will cost about S$150-S$200.
Cost Of Chronic Kidney Disease Treatment
According to a report by Channel New Asia (in partnership with the National Kidney Foundation):
- Medication for chronic kidney disease may cost around S$50 a month.
- Haemodialysis cost typically starts at S$2,500 per month.
- Peritoneal dialysis costs between S$1,300 and S$2,000 per month.
Cost Of Kidney Transplant
In Singapore, the kidney transplant programme is closely regulated. Commercial kidney transplantation is strictly prohibited under the Human Organ Transplant Act (HOTA), which aims to prevent organ trading and commercialisation. Information regarding the cost of kidney transplantation in Singapore is not publicly available.
Survival Rate
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%.
Contact Us For An Appointment
Preferred Renal Specialist You Can Consider
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 via the button below for an appointment with a kidney specialist.
FAQs
There are a lot of bubbles in the toilet when I urinate. Do I have kidney disease?
Foamy urine is one of the symptoms of kidney damage. Foamy urine that persists over time could indicate the presence of protein in the urine and could mean you have a kidney problem. You should consider seeing a doctor or renal physician for further investigation.
Does eating salty foods increase the chances of chronic kidney disease?
A high-sodium diet is a risk factor for chronic kidney disease. Studies have shown that adding salt to foods can significantly increase the risk of kidney damage.
Would I need dialysis if I have chronic kidney disease?
Patients will require dialysis when the disease has reached end-stage and kidney failure has set in. Patient who successfully undergoes kidney transplantation will not need dialysis.
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.