Division of Nephrology
The Division of Nephrology at the National University Hospital, is a single-specialty, multi-physician academic group practice housed within the Department of Medicine. It provides a continuum of care for patients with Stage 1 to Stage 5 Chronic Kidney Disease (CKD). Staff nephrologists work closely with nephrology nurses, medical social workers, dietitians, renal counsellors, pharmacists, therapists, and coordinators in providing care for inpatient and outpatients. The Division provides tertiary consultative services for Primary Care Providers and other specialties, and generally provide primary care for CKD 5 patients enrolled in our end-stage kidney disease programs.
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 5 CKD who are suitable for kidney replacement therapy. Peritoneal dialysis and maintenance hemodialysis are offered in satellite outpatient ambulatory centers. Patients with certain life-threatening conditions may, on occasion, receive dialysis care in our in-hospital in-center, outpatient high-dependency dialysis center. Patients are also evaluated for living and deceased donor kidney transplantation, followed by long-term 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 5 patients on dialysis or post-kidney transplantation.
Inpatient critical care nephrology services such as acute hemodialysis and continuous renal replacement therapies are provided for critically ill inpatients. A dedicated diagnostic and interventional nephrology program provides patients with rapid access to ultrasound diagnostics, kidney biopsy, peritoneal dialysis catheter insertion, and tunneled and non-tunneled hemodialysis catheter insertion.
The Division conducts clinical and academic training in general nephrology, dialysis, and transplantation through the 3-year Renal Medicine Senior Residency Program. One-year advanced clinical fellowships in kidney transplantation, hemodialysis, peritoneal dialysis, diagnostic and interventional nephrology, and critical care nephrology are also available. The Division does research in the epidemiology of CKD and kidney failure in Singapore, 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.
The consultative nephrology services include:
- Chronic kidney disease programs (diagnosis and intervention)
End-stage kidney disease programs (CKD 5)
- Kidney biopsy
- Glomerular disease
- Renal nutrition program
- Difficult hypertension
- Conservative/geriatric nephrology
Diagnostic and Interventional nephrology
- Chronic maintenance hemodialysis
- Continuous ambulatory peritoneal dialysis
- Kidney transplantation
- Peritoneal dialysis catheter insertion
- Hemodialysis catheter insertion
- Vascular access
- Kidney ultrasound