Debated in Parliament on 2 Aug 2022.
Mr Darryl David asked the Minister for Health (a) whether the Ministry can provide an update on the number of patients requiring kidney dialysis in the last five years; (b) how many of these patients have been able to secure a kidney transplant; (c) whether there is a coordinated programme to manage issues of kidney dialysis and kidney disease at the national level; and (d) how does the Ministry coordinate and partner with other organisations, such as the National Kidney Foundation and Kidney Dialysis Foundation in such matters.
End-Stage Renal Disease (ESRD) patients are those where kidney function has declined to the point where the kidneys can no longer function on their own and must receive dialysis or kidney transplantation. From 2017 to 2021, the number of ESRD patients on definitive dialysis, inclusive of haemodialysis and peritoneal dialysis (PD), increased from 7,007 to 8,668. Over the same period, 458 patients had a kidney transplant. The number of ESRD patients is expected to rise due to Singapore's ageing population.
Chronic kidney disease (CKD) is a long-term condition which involves a gradual loss of kidney function, usually due to risk factors such as diabetes and high blood pressure. If untreated, CKD can progress to ESRD. MOH has been working with the public and private healthcare providers, as well as social services agencies involved in dialysis services to tackle CKD care holistically, from upstream prevention efforts, timely diagnosis and implementing appropriate patient-centred management options. These partners include the National Kidney Foundation, Kidney Dialysis Foundation (KDF), Muslimin Trust Fund Association, Ang Mo Kio-Thye Hua Kwan Hospital and Buddhist Compassion Relief Tzu-Chi Foundation.
MOH has also been working with our healthcare partners to focus on upstream prevention to reduce ESRD prevalence. Since 2017, we have implemented the Holistic Approach to Lowering and Tracking Chronic Kidney Disease (HALT-CKD) programme, which uses a systematic approach to managing CKD. This includes early initiation and optimisation of kidney-protective medications and controlling risk factors for kidney damage, such as optimising management of diabetes, high blood pressure and addressing lifestyle factors, like smoking.
In 2018, NKF started the "Know Right, Start Right" programme in public healthcare institutions (PHIs) and deployed its teams on-site at the hospitals as care counsellors and coordinators, to provide pre-dialysis education and counselling services for patients in late stages of CKD. KDF has also been active in engaging the community to advocate for better kidney health, through public health talks and sporting events.
To ensure sufficient dialysis capacity in Singapore, MOH works collaboratively with all social services dialysis providers to develop new dialysis centres. In recent years, MOH has been working with providers to encourage suitable patients to opt for Peritoneal Dialysis (PD), which can be administered at home. MOH is also supporting service providers such as NKF, Ang Mo Kio-Thye Hua Kwan Hospital and Home Nursing Foundation to improve access to home support services for PD patients.
To improve kidney transplant uptake, MOH and the National Organ Transplant Unit have been working to promote greater awareness of organ donation and shift societal attitudes and views towards Living Donor Kidney Transplant.
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