IT IS disconcerting to read that kidney failure rates are increasing in Singapore ("A new dialysis patient every 5 hours"; May 10).
Two prominent risk factors highlighted are obesity and diabetes.
However, there are other risk factors as well.
It is helpful to note that kidney failure usually develops from chronic kidney disease, although acute failure can sometimes take place from trauma and other medical conditions.
The incidence and prevalence of chronic kidney disease is increasing at a rather alarming rate worldwide.
It is estimated that about 30 per cent of diabetic patients and 20 per cent of hypertensive patients have chronic kidney disease, which will lead to kidney failure without proper treatment and intervention.
Other risk factors for chronic kidney disease include hypercholesterolemia, obesity, a family history, systolic hypertension, atherosclerosis (inflammation and disease of the blood vessels) and proteinuria (increased urinary protein excretion).
Chronic kidney disease does not always end up in dialysis or a transplant; it contributes significantly to cardiovascular diseases, which include coronary heart disease, stroke, and often morbidity and death.
Singaporeans are encouraged to go for health screenings - and one result from these screenings may show albumin or protein in the urine examination.
This should not be ignored or interpreted as "normal". Further tests to exclude microalbuminuria and proteinuria should be undertaken.
If microalbuminuria is discovered and there is no medical intervention, chronic kidney disease may ensue.
We need to be aware that death due to cardiovascular disease for dialysis patients is about 30 per cent higher than for the general population and transplanted patients also need to go on long-term treatment to prevent rejection and other complications.
Dialysis and transplants also incur a high cost for the health budget of a population.
The message is: Preventive medicine is the way to go to avoid chronic kidney disease and renal failure.
We need to heed the call to combat obesity as well as unhealthy and sedentary lifestyles, and to go for early screenings and undertake preventive treatment to lower the rates of chronic kidney disease and kidney failure.
Quek Koh Choon (Dr)
