Key Causes of Recent Increase in Number of Patients Requiring Kidney Dialysis

Mr Yip Hon Weng asked the Minister for Health (a) what are the key causes of the recent increase in the number of patients requiring kidney dialysis; (b) what is the annual socioeconomic cost of dialysis in the past two years; (c) what are the targets that the Ministry has for eligible patients to take up peritoneal dialysis; and (d) how will the Government keep treatment accessible and affordable as demand grows.

Kidney dialysis is required for patients with End-Stage Renal Disease (ESRD), where their kidneys can no longer function adequately. The increase in the number of ESRD patients on dialysis is driven mainly by Singapore's ageing population and the prevalence of chronic diseases, particularly, diabetes and hypertension.

The ESRD, or kidney failure imposes a heavy personal and social cost. It is also a significant burden for the healthcare system. The Ministry of Health (MOH) has not done an estimation of the socioeconomic costs.

"Dialysis" is commonly understood to mean haemodialysis (HD). This is the more common mode of dialysis, but peritoneal dialysis (PD) has been shown to be more cost-effective and produces clinical outcomes comparable to HD and is done at home, providing convenience and independence for patients. Hence, MOH has adopted a PD-preferred strategy for medically suitable patients. MOH also provides higher subsidies for PD to encourage uptake and aims to raise the percentage of PD uptake amongst new dialysis patients from 19% now to 30% by 2025.

In working towards this target, MOH works with stakeholders on a set of pre-dialysis counselling, training and educational materials to help patients to perform PD independently at home. In April this year, MOH launched the National PD Home Support Programme, which provides home visits and more targeted counselling and support to help patients and their loved ones to gain confidence to perform PD at home.

MOH also provides means-tested subsidies to patients receiving HD and PD treatment, including those receiving PD home support. Patients can also use MediShield Life and MediSave for their dialysis treatment, and there is also charity assistance for those who face affordability concerns.