SINGAPORE - The number of people whose kidneys fail each year has risen significantly, pushed up by both the high rate of diabetes here and the ageing population.
In 2017, 1,999 people were diagnosed with chronic kidney disease stage 5 (CKD5) or end-stage kidney failure. This works out to 504.1 per million population.
It is a big increase compared with 2009 when 1,275 people were diagnosed with CKD5. The proportion was also very much lower, at 341.5 per million population.
Mr Tim Oei, chief executive of the National Kidney Foundation, the biggest provider of dialysis in Singapore with about 5,000 patients, said: "We are deeply concerned about the rising kidney failure cases... It has not shown any signs of slowing down."
He suggested that a "real-time" renal registry would make those in charge "more aware of the issue, its triggering factors and hence, drive towards a more responsive and precise management for kidney failure and its impacts".
The latest Singapore Renal Registry Annual Report released last month is for 2018, and much of the data reflected is for 2017.
Kidney failure remains disproportionately high among Malays. The age-standardised rate among Malays (676.9) was triple that of Chinese (233) and double that of Indians (309.5) here in 2017.
The majority of the new dialysis patients in 2018 - four out of five - were 50 to 79 years old.
However, the median age of patients starting on dialysis went up from 61.2 years in 2009 to 64.3.
Dr Stanley Liew, an endocrinologist with Raffles Hospital, said this is likely to be "due to our effective treatment of their diabetes and high blood pressure in delaying the onset age of dialysis".
Another reason, he said, is that people whose kidneys fail due to uncontrolled diabetes tend to be older than those whose failure is caused by kidney diseases.
Diabetes now accounts for 66 per cent of kidney failure, up from 62 per cent in 2009.
Dr Liew added: "Studies have shown that better control of diabetes can effectively prevent kidney failure. We should all continue our efforts in the prevention and control of diabetes."
The number of deaths among people on dialysis has gone up noticeably over five years - from 764 in 2014 to 914 in 2018.
The report said: "Cardiac event and infection were the two common causes of death among prevalent dialysis patients."
The survival of patients with kidney failure is far better for those who get a transplant, especially from a living donor.
The report added: "Patients who undergo transplant, regardless of the type of donor, had better survival than patients who were on dialysis."
In 2018, 111 kidney failure patients had transplants - 38 received a kidney from a deceased donor, 41 from a living donor and the rest had transplants done overseas.
There were far fewer local transplants carried out last year - 15 people received transplanted kidneys from deceased donors and 31 from living donors.
There were 340 people on the waiting list for a kidney transplant last year. The average waiting time for a kidney from a deceased donor is more than nine years.
Only 32.7 per cent of patients on dialysis survive 10 years, although this varied with age. Almost half of those aged below 60 live 10 years or more on dialysis, compared with 16.5 per cent of those who were 60 years or older.
Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission.
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