FAQs About Kidney Disease
Singapore has one of the highest rates of kidney failure in the world. With more modern lifestyle choices today, it is important to be understand more about the disease, and how best to prevent or delay its onset. In this edition, Dr. Lina Choong, Medical Director of KDF answers some of the frequently asked questions about chronic kidney disease.
Our kidneys have many functions which makes it indispensable to our help. A pair of healthy kidneys filter up to 200 litres of fluid every day. This allows the kidneys to eliminate toxins and other waste or substances which you may consume in excess. Through the production of urine, these are expelled from the body when you visit the toilet. They also help to regulate our blood pressure and produce some essential hormones.
When our kidneys do not function properly, toxins, harmful wastes and fluid accumulate in our body, which may result in symptoms of kidney failure.
Many of the complains patients have are usually quite non-specific in the form of being easily tired, poor appetite, itch, or malaise (“just not well”). More specifically, patients may complain of swelling in their feet and ankles, or breathlessness associated with production of less urine.
The only way to be sure is to get your doctor to run blood and urine tests on you. These tests can indicate if your kidneys are functioning optimally.
Certainly! A person can have early chronic kidney disease without symptoms. Damaged kidneys are still working enough such that you do not feel unwell. The only way to know for sure if you have chronic kidney disease is through blood and urine tests.
Kidney functions can be categorised into 5 stages,
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5 Stages of Kidney Disease |
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Kidney Function / Glomerular Filtration Rate (GFR) |
Description |
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Stage 1 |
> 90% |
Normal Function |
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Stage 2 |
60 to 89% |
Mildly Decreased Function |
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Stage 3 |
30 to 59% |
Mild to Moderately Decreased Function |
|
Stage 4 |
15 to 29% |
Severely Decreased Function |
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Stage 5 |
< 15% |
Kidney Failure |
You only need a kidney replacement if the kidney function is severely low. This can be either through a kidney transplant or dialysis. Kidney transplantation requires a healthy kidney to be surgically placed into the body. A transplanted kidney will usually function normally upon surgery but requires support from medications to maintain it inside a different environment. There are also surgical risks to consider. Thus, transplantation requires a significant amount of planning. Most patients therefore start off with dialysis.
There are 2 types of dialysis treatments – Haemodialysis and Peritoneal Dialysis.
Haemodialysis filters wastes from the blood with the help of an artificial kidney and a special solution (called the dialysate). It aims to normalise the blood concentrations as much as possible. A dialysis machine is needed to manage settings for the treatment. In some other countries, it can be performed in the patient’s home if patients are trained for it. In Singapore, haemodialysis is performed in a haemodialysis centre by nursing staff. Patients undergo this treatment usually 3 times a week, 4 hours a day.
Peritoneal dialysis uses a lining known as the peritoneum that is found within the abdominal space. There are many blood vessels within this lining which can carry the waste and toxins within it. The abdominal cavity is filled with fresh dialysate which reaches the blood in these blood vessels. After dwelling for between 2 to 4 hours (depending on the treatment type), it is drained out. A few exchanges are needed every day to provide adequate treatment. However, patients have the flexibility to do this treatment in the comfort of their home.
What can I do to prevent kidney failure?
Even if you have mild kidney failure, these methods are used to slow down the progression to more advanced stages of kidney failure.
