Chronic kidney disease (CKD) is a gradual loss of the kidneys' filtering ability, usually due to high blood pressure or diabetes. When kidney function is seriously impaired, dangerously high levels of fluid and wastes can accumulate in the body.
In the early stages of CKD, the patient may have few signs or symptoms. In fact, many people with CKD do not realize they have a problem until their kidney function has decreased to less than 15% of normal, at which time they may exhibit symptoms.
The main goal of treatment of CKD is to halt or delay progression of the disease, usually by controlling the underlying cause. CKD can progress to end-stage kidney disease, which can be fatal if not treated with artificial filtering (dialysis) or a kidney transplant.
If you have a chronic medical condition that puts you at increased risk of CKD your doctor is likely to monitor your blood pressure and kidney function with urine and blood tests during regularly scheduled office/clinic visits.
Call your doctor if you experience any of the signs and symptoms of CKD between visits. These may include a change in urination patterns or quantity, dark or cola-coloured urine, unexplained weight loss, nausea, vomiting, fatigue or a yellowish-brown cast to your skin.
Even if you have no risk factors for kidney failure, see your doctor immediately if you notice that you are urinating much more or much less than usual or if you see any blood in your urine.
Staff in the Division are skilled at evaluation for various diseases of the kidney and urinary tract. These conditions include haematuria (blood in the urine), proteinuria (protein in the urine), other urine abnormalities, high blood pressure, diabetic nephropathy (kidney involvement due to diabetes), glomerulonephritis (like IgA, lupus-related renal diseases) electrolyte disorders, kidney stones, cysts and urinary tract infections to name a few.
Patients with kidney failure at various stages can also be evaluated for the cause of kidney failure and prognosis in a holistic disease management based manner. Patients are evaluated through the use of laboratory tests, radiographic and ultrasound scans and where appropriate, real-time ultrasound-guided kidney biopsy patients are also provided medical and dietary therapy to slow progression of kidney disease. Patients with worsening kidney function are counselled on their treatment options.
We provide evidence-based treatment for kidney diseases in all its stages and treat kidney failure using various modalities of renal replacement therapy, including acute dialysis, haemodialysis, peritoneal dialysis and kidney transplantation.
Patients with end-stage kidney failure who opt for long-term haemodialysis will receive comprehensive treatment including dietary counseling, hypertension control, evaluation and management of cardiac risk factors, anemia and renal bone disease.
The Division also operates a chronic haemodialysis centre for stable patients (the NUH Dialysis Centre at a satellite location at the Singapore Labour Foundation Building on Thomson Road). We also provide selective high dependency haemodialysis for those patients with high cardiovascular risk who are often deemed unsuitable for haemodialysis in Singapore.
Kidney transplantation is an important form of treatment for kidney failure and can be performed for suitable patients even without embarking on dialysis (pre-emptive transplant).
Our programme offers evaluation of patients with kidney failure for suitability for transplantation, evaluation of potential donors for suitability to donate and coordinates the pre- and post-transplant care of transplant patients and donors. Staff together with kidney transplant surgeons, other specialists and transplant coordinators provides long-term care for transplant patients.
A number of milestone transplants have been successfully conducted at NUHS: the first Asian combined bone marrow and kidney transplant, the second ABO (blood group) incompatible transplant in Singapore, as well a number of high-risk complicated cases.