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Stemming the tide of chronic kidney disease: A focus on primary care prevention

The prevalence of chronic kidney disease (CKD) among Singapore residents aged 18 to 74 years rose significantly from 8.8% in 2019–2020 to 13.8% in 2021–2022.1,2 Singapore ranks third globally for treated end-stage kidney disease (ESKD), with a median survival of 6 years post-dialysis.3 Diabetic nephropathy was the leading cause...

Five-year outcomes of a holistic programme for managing early chronic kidney disease in primary care

Singapore has the third highest incidence and sixth highest prevalence of end-stage kidney disease (ESKD) in the world.1 Globally, chronic kidney disease (CKD) is estimated to affect over 850 million people, with a prevalence of 13.4% among adults worldwide.2 Diabetes is the main cause of ESKD in new patients...

Evaluating the role of technology in disseminating education to patients with chronic kidney disease

Dear Editor, The optimal management of chronic kidney disease (CKD) requires lifestyle changes and adherence to long-term medications. Knowledge is a component of health literacy and is needed for self-management. Limited health literacy can lead to negative outcomes, such as adverse clinical events and mortality.1 Using technology to improve patients’ knowledge...

Trends in fluid overload-related hospitalisations among patients with diabetes mellitus: The impact of chronic kidney disease

Diabetes mellitus (DM) is a major global health problem, contributing to significant clinical disease burden, healthcare expenditure and societal costs.1 In Singapore, DM accounts for 2.9% of disability-adjusted life years and 4.3% of years lived with disability.2,3 By 2030, it is projected to cost approximately USD 1.89 billion in...

Thiazide diuretics in chronic kidney disease: Is there still a role?

“The young physician starts life with 20 drugs for each disease, and the old physician ends life with one drug for 20 diseases.” — William Osler Hypertension is both a cause and consequence of chronic kidney disease (CKD). As such, the prevalence of hypertension is high among CKD patients and...

Plasma selenium and zinc alter associations between nephrotoxic metals and chronic kidney disease: Results from NHANES database 2011–2018

Chronic kidney disease (CKD) is a clinical condition comprising persistent changes in kidney function or structure, or both. It is characterised by irreversible and progressive evolution, increasing the risk of complications and mortality. As the 16th leading cause of mortality worldwide, CKD affects 8–16% of the global population.1,2 Clinically,...

Micronutrients and kidney health

Chronic kidney disease (CKD) is a structural and functional disorder of the kidney caused by many diseases, such as diabetes, hypertension and glomerular disease.1 There are many factors that contribute to the development and progression of CKD, and often, we do not look at the exposure of heavy metals...

Association between lower phase angle and chronic kidney disease progression in type 2 diabetes patients

Chronic kidney disease (CKD) is a global public health problem with an estimated prevalence of 13.4%.1 One of the key drivers of the global increase in CKD is the rising prevalence of diabetes mellitus (DM).1 CKD affects about 25–40% of patients with type 2 diabetes mellitus (T2DM).2 A few...

Association between self-care and chronic kidney disease in patients with type 2 diabetes mellitus

Dear Editor, Chronic kidney disease (CKD) is one of the key complications occurring in 25–40% of patients with type 2 diabetes mellitus (T2DM).1 Our earlier study also showed that CKD was present in 53% of patients with T2DM recruited from a secondary care diabetes centre and primary care polyclinic...

Identifying high-risk hospitalised chronic kidney disease patient using electronic health records for serious illness conversation

In-hospital cardiopulmonary resuscitation (CPR) for chronic kidney disease (CKD) patients is shown to have lower survival1 and a higher proportion of survivors on maintenance haemodialysis were discharged to skilled nursing facilities.2 Despite that, haemodialysis patients still preferred CPR during cardiac arrest3 and there are lower do-not-resuscitate orders for the...

Death and cardiovascular outcomes in end-stage renal failure patients on different modalities of dialysis

End-stage renal failure (ESRF) is a major cause of morbidity and mortality worldwide, including Asia.1 In Singapore, incidence of chronic kidney disease (CKD) stage 5 has increased from 383.9 per million population (PMP) in 2010 to 414.8 PMP in 2015. Incidence of patients requiring dialysis has increased in tandem....

Survival outcome of haemodialysis and peritoneal dialysis

End-stage renal disease (ESRD) is a challenging and growing health issue, with number of patients increasing globally. The use of dialysis has greatly improved the survival and life expectancy of ESRD patients. Haemodialysis (HD) and peritoneal dialysis (PD) are 2 broad dialysis modalities used for ESRD. Despite the advancement...

Impact of COVID-19 infections among kidney transplant recipients

Dear Editor, More than 2 years since the start of the COVID-19 pandemic, cases continue to climb despite global efforts at viral control. This is largely driven by the emergence of viral variants. In the later part of 2021, the Delta variant was the predominant variant circulating globally, and was...

Paediatric living-donor liver and kidney transplantation during COVID-19

Dear Editor, The coronavirus disease 2019 (COVID-19) pandemic has impacted global healthcare including paediatric solid organ transplantation (SOT). We report our experience of resuming paediatric living-donor SOT during COVID-19, which took into account safety considerations for living donors, paediatric recipients and the transplant healthcare team. The US Centers for Disease...

Retardation of Kidney Failure – Applying Principles to Practice

By 2010 there will be more than 2 million patients worldwide on maintenance dialysis, a 400% increase in 20 years.1 This increase, occurring predominantly in developing nations, is being driven especially by a worldwide increase in the incidence of diabetes, and is too great to be offset by increased...

Drug-induced Kidney Disease – Pathology and Current Concepts

Departing from the usual account of drug-induced renal disease according to the specific type of drug, we divide this discussion into 3 main areas - glomerular injury, vascular injury and tubulointerstitial changes. In doing so, more emphasis will be placed on morphological findings although functional toxicity (with little or...

National Health Survey on the Prevalence of Urinary Abnormalities in the Population: then and now (1975 to 2012)

In the planning of a tuberculosis prevalence survey in Singapore in 1975, it was decided to include a urine examination of the respondents using Labstix (Ames Company, Elkhart, Indiana, USA). Respondents found to have proteinuria, haematuria or both in the examination centres were then referred to the Department of...

Kidney Cancer and Diabetes Mellitus: A Population-Based Case-Control Study in Taiwan

Kidney cancer accounts for 3% to 4% of all cancers. In a systematic review by Mathew and et al,2 the incidence of kidney cancer was the highest in France (16.1 per 100,000 man-years) and the lowest in India (0.9 per 100,000 woman-years) during 1988 to 1992. A trend analysis in...

Empagliflozin-induced severe osmotic nephrosis and acute renal injury in advanced chronic kidney disease

Diabetic kidney disease remains a significant disease burden globally and is associated with increased medical costs once chronic kidney disease (CKD) ensues. Therefore, optimisation of CKD management through glycaemic control and albuminuria reduction are key strategies for retarding renal deterioration. Sodium glucose cotransporter-2 (SGLT-2) inhibitors are a new class...