Kidney Failure and Prevention: What Every Singaporean Should Know

Disclaimer: This content is for educational purposes only and is not a substitute for professional clinical advice from a healthcare provider.

Kidney failure is a growing and largely preventable health problem in Singapore. This guide explains what your kidneys do, why they fail, and most importantly how to prevent kidney failure from affecting your health.

What Do Your Kidneys Do?

The kidneys are a pair of bean-shaped organs located at the posterior wall of the abdomen. Each day, the two kidneys filter the body’s entire blood supply dozens of times over, excreting about 1.5 to 2.5 litres of urine and removing waste products and excess water in the process.

Beyond filtration, your kidneys perform several other vital functions. They maintain the body’s balance of salts such as sodium, potassium, calcium, and phosphate, as well as acid substances. They also release key hormones: renin, which regulates blood pressure; erythropoietin, which stimulates red blood cell production in the bone marrow; and an activated form of Vitamin D, which helps maintain healthy bone structure.

When the kidneys are no longer able to perform these functions adequately, the consequences affect the whole body.

Understanding Kidney Failure

Kidney failure is a condition where the kidneys are incapable of performing their normal functions. This results in toxic substances such as urea and creatinine accumulating in the body. Blood creatinine level is most often used by doctors as a measure of the degree of kidney failure. Generally, when creatinine levels in the blood reach 900 µmol/L, the patient should start on dialysis.

In kidney failure, the volume of water in the body increases, causing tissue swelling. Excess salt and water retention may lead to high blood pressure, swelling of the legs, face and abdomen, and breathlessness. As the kidneys fail to excrete phosphate, blood phosphate levels rise and calcium levels fall, resulting in bone disease and an increased risk of fractures (worsened by the reduction in active Vitamin D). Inadequate production of erythropoietin leads to anaemia.

Kidney failure is a growing problem in Singapore. Approximately six new cases of kidney failure are diagnosed every day^[1], and Singapore has one of the highest rates of diabetes-induced kidney failure in the world. The most common cause of kidney failure in Singapore is diabetes, accounting for about two in three new end-stage renal disease cases^[1]. Other causes include glomerulonephritis, kidney stones, polycystic kidneys, systemic lupus erythematosus (SLE), uncontrolled hypertension, and certain medications.

Symptoms of Kidney Failure

Kidney disease is often called a silent killer. In mild kidney failure, no symptoms are present, although kidney function tests will show abnormalities. This is why regular screening is so important, especially for those with risk factors such as diabetes or high blood pressure.

As kidney failure progresses, patients may experience the following symptoms:

• Pale or sallow complexion
• Persistent fatigue
• Shortness of breath
• Body itch
• Poor appetite, sometimes accompanied by nausea and vomiting
• Swelling of the face and legs
• Frequent urination at night
• Passing little or no urine

If you or a loved one are experiencing any of these symptoms, consult a doctor promptly. Early detection can significantly slow the progression of kidney disease.

How to Prevent Kidney Failure

While not all causes of kidney failure can be avoided, there are clear steps you can take to reduce your risk and slow the progression of existing kidney disease. Those with diabetes, high blood pressure, or a family history of kidney disease are at higher risk and should be especially proactive.

Manage Underlying Health Conditions

Control blood sugar levels. Diabetes is the leading cause of kidney failure in Singapore. If you have diabetes, keeping your blood sugar well managed is the single most important step you can take to protect your kidneys.

Monitor blood pressure. Uncontrolled high blood pressure accelerates the progression of any underlying kidney disease. Have your blood pressure checked regularly and take prescribed medication as directed.

Be cautious with medications. Painkillers, particularly non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, can cause kidney damage if taken regularly or in high doses. Always consult a doctor or pharmacist before taking them, especially if you have existing kidney concerns.

Avoid harmful substances. Toxins, pesticides, and illegal drugs can cause significant kidney damage. Long-term exposure or misuse of these substances places serious strain on your kidneys.

Adopt Kidney-Friendly Healthy Habits

Lifestyle choices have a direct impact on kidney health. The following habits can help protect your kidneys over the long term:

• Avoid sweet, salty, and oily food. Excess sugar contributes to diabetes, while excess salt raises blood pressure. Both are key risk factors for kidney failure.
• Avoid excessive alcohol consumption. Alcohol raises blood pressure and places additional strain on the kidneys.
• Drink adequate water daily. Staying well hydrated helps the kidneys clear sodium, urea, and toxins from the body.
• Eat a well-balanced diet with fruits, vegetables, whole grains, and lean protein. Avoid high-protein diets that can overtax the kidneys.
• Exercise regularly. Aim for at least 150 minutes of moderate physical activity per week to maintain a healthy weight and keep blood pressure in check.
• Do not smoke. Smoking damages blood vessels throughout the body, including those supplying the kidneys, and can accelerate kidney damage.
• Go for routine medical check-ups. Because early-stage kidney disease rarely causes noticeable symptoms, regular blood and urine tests are important for early detection.

When Kidney Failure Cannot Be Prevented

Chronic kidney failure is generally not reversible. When the kidneys have failed beyond the point of recovery, the two main treatment options are dialysis and kidney transplantation.

The Kidney Dialysis Foundation (KDF) supports needy kidney patients in Singapore who require life-sustaining dialysis treatment. If you or someone you know has been diagnosed with kidney failure and needs financial assistance to access dialysis, contact KDF to find out about our subsidised treatment programmes.

Frequently Asked Questions About Kidney Failure Prevention

What is the most common cause of kidney failure in Singapore?

Diabetes is the leading cause, accounting for about two in three new end-stage renal disease cases in Singapore^[1]. High blood pressure is the second most common cause.

Can kidney failure be reversed?

Acute kidney failure may be reversible if the underlying cause is identified and treated early. Chronic kidney failure, however, is generally not reversible. The goal of treatment is to slow its progression.

How do I know if my kidneys are at risk?

If you have diabetes, high blood pressure, a family history of kidney disease, or are above 60 years of age, you are at higher risk. Regular blood and urine screening tests are the best way to monitor your kidney health.

What foods should I avoid to protect my kidneys?

Limit foods high in salt, sugar, and saturated fat. Avoid high-protein diets, reduce alcohol consumption, and stay well hydrated with water rather than sugary or carbonated drinks.

When should I see a doctor about my kidneys?

See a doctor if you experience persistent fatigue, swelling in the legs or face, changes in urination patterns, or unexplained shortness of breath. Even without symptoms, regular screening is recommended for those with known risk factors.

 

 

Resources

[1] National Kidney Foundation (NKF) Singapore: Key Statistics

[2] HealthHub Singapore: Kidney Health and Kidney Care