Care at NUH


The Division of Nephrology is a single-specialty, multi-physician academic group practice housed within the University Medicine Cluster. Nephrologists work closely with nephrology nurses, medical social workers, dietitians, renal counsellors, pharmacists, therapists, and coordinators in providing care for inpatients and outpatients. The division provides tertiary consultative services for Primary Care Providers and other specialties, and provides primary care for CKD G5 patients enrolled in our end-stage kidney disease programmes. 

Our Division embraces a vision of a creative and inclusive nephrology community that will have a global impact on all stakeholders in kidney disease management, from healthcare providers to patients and their caregivers. We will harness our academic network of innovation, translational science, and novel health services and continuously implement these to enhance our clinical practice. Our mission is to provide affective care for our people, build their skills to achieve the former, and, in turn, deliver effective patient care. 

The division provides a continuum of care for patients with stage G1 to stage G5 Chronic Kidney Disease (CKD). The division evaluates and manages patients with hypertension, diabetic kidney disease, glomerulonephritis, acute kidney injury, and other kidney diseases. The division provides a full range of options for patients with stage G5 CKD who are suitable for maintenance kidney replacement therapy. Peritoneal dialysis (both continuous and nocturnal) and haemodialysis (including haemodiafiltration) are offered as standard of care. There is the option of home-based dialysis as well as dialysis in satellite outpatient ambulatory centre. Button-hole (blunt needle) cannulation service is offered to suitable patients. Patients with certain life-threatening conditions may, on occasion, receive dialysis care at our Inpatient Dialysis Centre or outpatient high-dependency dialysis facility at the Renal Centre. Patients are also evaluated for living and deceased donor kidney transplantation, followed by long-term care and management of their pre- and post-transplant course. High risk transplantation, such as cross-match positive and ABO-incompatible living donor transplants, are also routinely performed with good outcomes. Currently, the division sees and manages more than 2500 CKD G5 patients on dialysis or post-kidney transplantation.  

 Inpatient critical care nephrology services such as acute haemodialysis and continuous renal replacement therapies are provided for critically-ill inpatients. A dedicated diagnostic and interventional nephrology programme provides patients with rapid access to ultrasound diagnostics, kidney biopsy, peritoneal dialysis catheter insertion, as well as tunnelled and non-tunnelled haemodialysis catheter insertion. 
Our Services

Chronic Kidney Disease Programs (Diagnosis and Intervention) 

Glomerular diseases 

Patients with disease within the kidney itself, in particular with blood (hematuria) and protein (albuminuria or proteinuria) in the urine, require a careful work-up as many of such diseases are chronic. Proper treatment may abolish the disease completely or reduce the disease activity, thus slowing down the progression of Chronic Kidney Disease (CKD). Special blood tests are sometimes needed, and a kidney biopsy is often required to make the diagnosis. 

Renal nutrition programme 

We are what we eat! Proper nutrition is the key essential step for managing CKD and End-Stage Kidney Disease (ESKD). A good diet is essential to reduce the burden of other diseases associated with kidney disease, such as hypertension, diabetes, and early atherosclerotic disease (heart attacks and strokes). 


Patients with CKD and patients opting for conservative management may attempt the Very-Low Protein Diet with essential keto-amino acid supplementation programme, coupled with regular follow-ups with the dietitian. 

In pre-dialysis ESKD patients and patients who are already on dialysis, good nutrition is needed to prevent complications, in particular infections, and muscle wasting. Regular assessment using tools such as bioimpedance spectroscopy, blood test for nutrition markers (albumin and pre-albumin), and body measurements will help clinicians in prescribing the most appropriate diet and supplements. 

Difficult hypertension 

There are many causes of hypertension (high blood pressure), which is a disease multiplier. Hypertension increases the risk of rapid progression of kidney disease, strokes, and heart attacks. Patients with poorly controlled hypertension will undergo a careful evaluation of the likely cause of their resistant hypertension. Strict residual risk is abolished by tracking goals using a variety of monitoring methods, including 24-hour ambulatory blood pressure monitoring, home blood pressure monitoring, and bioimpedance spectroscopy (for blood volume assessment).   


Patients suspected of a specific treatable cause of hypertension may be referred for specific therapy, such as surgery, renal denervation, renal artery angioplasty, amongst others. 

Geriatric nephrology 

Palliative nephrology 


Patients with ESKD who are no longer able to undergo dialysis or are developing symptoms while on a conservative treatment programme will be enrolled into a palliative care programme, where the goals of management are to reduce symptoms and discomfort. These patients and their next-of-kin will be referred to specialist doctors and nurses in palliative care. 


Palliative care may be performed at home whereby healthcare professionals will make regular home visits, or where appropriate, patients are admitted to a hospice. 


End-Stage Kidney Disease Programs (CKD G5) 

Chronic maintenance haemodialysis 

Patients who are unsuitable for, or can no longer undergo peritoneal dialysis, are placed on haemodialysis. Patients undergo a minor surgery to connect a vein to an artery and create an arterio-venous fistula (AVF). Once the AVF is mature, the needles can be inserted for dialysis to take place. Blood is removed and passed through a machine for processing (removing waste and excess water), and finally returned to the patient. There are several formats of undergoing haemodialysis. Where suitable, patients can perform home haemodialysis (short daily dialysis or nocturnal dialysis). More often, patients travel to an outpatient dialysis centre three times a week, and undergo dialysis for about five hours each time. 

Peritoneal dialysis 

The initial kidney dialysis therapy for ESKD is Peritoneal Dialysis (PD), unless there are medical reasons not to do so. In the life-cycle of ESKD, PD is started to take advantage of the remaining very low kidney function (residual kidney function). This allows a patient to start with low doses of PD, and to increase the intensity of treatment as the CKD G5 progresses in severity. 

Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD) are offered. Patients and their caregivers are trained to perform PD at home or at convenient places.  The PD programme is run by a team of nephrologists, renal dietitians, and specialist nurses.  Regular follow-up, surveillance testing, and dietary counselling provide holistic care to PD patients to minimise avoidable complications of ESKD. 

Kidney Transplantation 

Kidney transplantation is the initial preferred option for ESKD, and can be performed for suitable patients even without embarking on dialysis (pre-emptive transplantation). Kidney transplantation offers the best clinical outcomes for ESKD. Patients are evaluated for their suitability for transplantation, and potential donors are assessed for suitability to donate. Singapore citizens may be placed on the National Deceased Donor kidney transplantation programme. Because of the long wait-time for deceased donor kidneys, where suitable and available, all ESKD patients are encouraged to undergo living (related or unrelated) kidney transplantation. A team of nephrologists, kidney transplant surgeons, transplant coordinators, and nurses provide long-term integrated care, and coordinates the pre- and post-transplant care of transplant patients and donors.  

Diagnostic and Interventional Nephrology 

  • Kidney biopsy 

  • Kidney ultrasound 

  • Peritoneal dialysis catheter insertion 

  • Haemodialysis catheter (tunnelled and non-tunnelled) insertion 

  • Vascular access ultrasonography 

  • Vascular access endovascular intervention

Our Facilities

For contact details, operating hours and directions, please select the respective facility links

University Medicine Clinic

13b Medicine Clinic

Renal Centre

NUH Dialysis Centre at Alexis

National University Centre for Organ Transplantation (NUCOT)

Patient Education

Preparing for haemodialysis? Find out more about vascular access creation in this video.

Our Education

​The division conducts clinical and academic training in general nephrology, dialysis, and transplantation through the 3-year Renal Medicine Senior Residency Programme. One-year advance clinical fellowships in kidney transplantation, haemodialysis, peritoneal dialysis, diagnostic and interventional nephrology, and critical care nephrology are also available. Find out more here.

Our Research
The Division conducts research in the epidemiology of Chronic Kidney Disease (CKD) and kidney failure in Singapore, as well as the estimation and measurement of kidney function (glomerular filtration rate) in healthy and the multi-ethnic Asian CKD populations. There are also studies aiming to improve the identification and classification of kidney health and disease using novel biomarkers. Research in clinical transplantation is on post-transplantation outcomes and complications, and pharmacokinetics of immunosuppressive drugs, surrogate markers of interstitial fibrosis and tubular atrophy, whereas basic research has been on immune monitoring post-transplantation. The Division is also involved in multiple collaborations with national and international groups in investigator-initiated clinical research in kidney disease in addition to sponsored clinical trials.
Last updated on
Best viewed with Chrome 79.0, Edge 112.0, Firefox 61.0, Safari 11
National University Health System
  • National University Hospital
  • Ng Teng Fong General Hospital
  • Alexandra Hospital
  • Jurong Community Hospital
  • National University Polyclinics
  • Jurong Medical Centre
  • National University Cancer Institute, Singapore
  • National University Heart Centre, Singapore
  • National University Centre for Oral Health, Singapore
  • NUHS Diagnostics
  • NUHS Pharmacy
  • Yong Loo Lin School of Medicine
  • Faculty of Dentistry
  • Saw Swee Hock School of Public Health
Back to Top