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Home > Patients & Visitors > Diseases & Conditions > Abdominal > Chronic Kidney Disease

Chronic Kidney Disease

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Definition

Chronic kidney disease (CKD) is a gradual loss of your 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 your body.
In the early stages ofCKD, you may have little signs or symptoms. Infact , many people with CKD do not realize they have a problem until their kidney function has decreased to less than 15% of normal when they may have 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 t artificial filtering (dialysis) or a kidney transplant


Symptoms


  • Signs and symptoms may include any of  the following:
  • High blood pressure
  • Decreased urine output or no urine output
  • Darkly colored urine
  • Anemia
  • Nausea or vomiting
  • Loss of appetite
  • Sudden weight change
  • A general sense of discomfort and unease (malaise)
  • Fatigue and weakness
  • Muscle twitches and cramps
  • Swelling of the feet and ankles 
  • Yellowish-brown cast to your skin
  • Persistent itching


CKD can be difficult for you or your doctor to detect initially. Signs and symptoms are often nonspecific, meaning they can also be attributed to other illnesses. In addition, because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms of chronic kidney failure may not appear until irreversible damage has occurred.

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When to seek medical advice

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-colored urine, unexplained weight loss, nausea or 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.

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Treatment (provided by NUH)


General Nephrology

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 holisitic disease management based manner.

Patients are evaluated through the use of laboratory tests, radiographic and ultrasound scans and where appropriate, realtime-ultrasound guided kidney biopsy atients are also providedmedical and dietary therapy to slow progression of kidney disease and those with worsening kidney function are counseled on the 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.


Chronic Haemodialysis


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 selectiveHigh Dependency haemodialysis for patients with high cardiovascular risk and often deemed unsuitable for haemodialysis in Singapore.

Peritoneal dialysis

Staff are also skilled in evaluation and training of patients for Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis (CAPD) or Automated Peritoneal Dialysis (APD). Training is offered on an outpatient basis to both patients and their relatives or helpers. A  disease management care team consisting of nephrologists, renal dietitians and specialist nurses provides dietary counseling and holistic care to PD patients to minimize complications of kidney failure.

Kidney transplant

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 mile stone transplants have been done at NUHS: the first Asian combined bonemarrow and kidney transplant and the second ABO (blood group) incompatible transplant in Singapore as well a number of high risk complicated cases.

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Appointment and Enquiry


Specialized Outpatient Consultation


Location

Main Building, Level 1 
Medicine Clinic D

Operating hours

Mondays to Fridays (Sundays and Public Holidays Closed)
8.30am to 5.30pm
Saturdays
8.30am to 12 noon

Contact details        

Tel: (65) 6772 5733


High Dependency Haemodialysis



Location

Main Building, Level 5
Renal Therapeutics Suite

Operating hours

Mondays to Saturdays (include Public Holidays)
8.00am to 6.30pm
Sundays Closed

Contact details 

Tel: (65) 6772 5424



Inpatient Haemodialysis

 

Location

Main Building, Level 5     
Renal Unit

Operating hours

Mondays to Saturdays (inclusive Public Holidays)
Sundays Closed

Contact details

Tel: (65) 6772 5472


Peritoneal Dialysis Outpatient Programme



Location

Main Building, Level 1     
Renal Center

Operating hours

Mondays, Thursdays and Fridays
9.00am to 5.30pm
Tuesdays and Wednesdays
11.00am to 7.00pm
Saturdays/Sundays/Public Holidays Closed

Contact details

Tel: (65) 6772 5432

Peritoneal Dialysis Inpatient Programme



Location

Main Building, Level 5     
Renal Therapeutics Suite

Operating hours

Mondays to Sundays (include Public Holidays)
7.00am to 9.00pm

Contact details

Tel: (65) 6772 5471


NUH Dialysis Center



Location

#B2-00 SLF Building, 510 Thomson Road

Operating hours

Mondays to Saturdays (Inclusive of Public Holidays)
Closed on Sundays
6.30am to 9.00pm (last patient starts dialysis at 5.00pm)

Contact details

Tel: (65) 6259 9217


Kidney Transplant Office



Location

Main Building 1, Level 2, Liver and Kidney Transplant Office

Operating hours

Mondays to Fridays
9.00am to 5.30pm
Saturdays/Sundays/Public Holidays Closed

Contact details

Tel: 65) 6772 4112

For patients seeking advice on kidney disease

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