NUH sets up registry to track 'kidney attacks'

"KIDNEY attacks" strike suddenly and may afflict as many as one in 20 hospitalised patients.

They cause damage to the organ and are often triggered by severe infections, heart failure and other critical illnesses.

Now, the National University Hospital (NUH) is setting up a registry to track the number of cases.

Professor A. Vathsala, the head of its division of nephrology, said the move is necessary as the condition, also known as acute kidney injury, is being recorded more frequently in the United States.

It is estimated that at least 5 per cent of hospitalised patients may suffer from acute kidney injury, with the incidence higher among those under intensive care.

A survey by NUH found that about 28 per cent of the patients in the medical intensive care unit had acute kidney injury.

About 40 per cent of those hit by kidney attacks have a severe form that will require dialysis. If early treatment is not sought, the condition can turn chronic and require long-term care, and could even be fatal.

The registry will help doctors identify those most at risk so that there can be early intervention. Its data will also track the changing trends in acute kidney injury and allow for resource planning, said Prof Vathsala.

The elderly, as well as those with underlying chronic conditions such as diabetes, cancer and stroke are more at risk of kidney attacks.

Madam Yang Choo Tee is one example. About two months ago, her legs suddenly became swollen, her stomach grew bloated, and she was not passing much urine.

The 93-year-old, who has high blood pressure and diabetes, was found to have acute kidney injury, and is now undergoing dialysis treatment.

"As the population gets older and medical care improves, more and more patients with complex medical problems are being kept alive," said Dr Titus Lau, a senior consultant at NUH's nephrology division. "We do see an increasing number of them having kidney problems requiring some form of dialysis support either for the long term or short term."

With the demand for dialysis treatment expected to grow due to both acute and chronic kidney failure, experts are also pushing for peritoneal dialysis to relieve demand for dialysis services.

In peritoneal dialysis, which can be performed at home, a dialysis fluid is fed directly into a tube in the abdomen - meaning the patient does not have to go to a centre and be hooked up to a machine, as in haemodialysis.

"It allows greater flexibility, is gentler, and is associated with fewer blood infections," said Prof Vathsala.

At the Singapore General Hospital, about 400 new end-stage renal failure patients started on dialysis in 2011.

About 73 per cent were on haemodialysis and 27 per cent were on peritoneal dialysis.

The National Kidney Foundation hopes to see the number of patients on peritoneal dialysis go up from 22 per cent, to 30 to 35 per cent.


This story was first published in The Straits Times on April 1, 2013

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