Dark red, smooth and shaped like a bean, the kidney is one of the more immediately recognisable organs of the human body. It is also one of the hardest-working.

Kidneys filter out waste products and extra fluid from the blood; they also regulate blood pressure, electrolyte levels and the body’s pH levels. A healthy pair of kidneys can filter up to 180 litres of fluid and produce about 1.5 litres of urine daily. Without this critical filtration system to maintain balance in the body, toxins like urea can accumulate. These can affect the brain and the heart. 

Kidney Failure Symptoms

“As waste products build-up, you may begin to experience shortness of breath, swelling in the legs, weakness, lethargy, confusion, itching, loss of appetite, nausea and vomiting,” says Dr Weng Wanting, Associate Consultant, Department of Renal Medicine, Tan Tock Seng Hospital. “The inability [of the kidney] to remove potassium from the blood may lead to abnormal heart rhythms and sudden death.” 

Kidney failure, also known as end-stage renal disease, is on the rise in Singapore. According to the National Kidney Foundation (NKF), there are about five new kidney failure patients a day and one new dialysis patient every five hours. In 2014, about 1,730 Singaporeans suffered from kidney failure, up from 1,657 the year before.

Causes of Kidney Failure

Why do kidneys fail? There are many reasons why a kidney stops working. Causes of kidney failure include diabetes mellitus, hypertension and glomerulonephritis. Risk factors for kidney disease include a family history of kidney disease, cardiovascular disease, older age and abnormal kidney structure. For many people, kidney failure is often the result of complications caused by an unhealthy lifestyle.

Diabetes and high blood pressure are the two major causes of kidney disease, and both of these conditions are on the rise in Singapore. Diabetes affects about one in nine adult Singaporeans, while high blood pressure affects about one in four adult Singaporeans. According to the Singapore Renal Registry Annual Report 2015, end-stage renal failure due to diabetes accounted for two-thirds of new patients on dialysis.

Kidney Failure: Treatment Options

If your kidneys fail, your options are dialysis or a kidney transplant. Each option has its pros and cons. Some patients may also choose to be managed conservatively, and life expectancy may range from several weeks to a few months. 

Some dialysis patients experience low blood pressure, muscle cramps, itching, sleep apnoea or anaemia. Patients undergoing dialysis also have to adhere to a special diet and limit how much they eat and drink. 

Transplant patients require special medications for life to prevent the body from rejecting the new kidney. Plus, the new kidney is still at risk of failing, especially if poor lifestyle or dietary habits continue or if the patient does not follow the prescribed post-transplant medication and treatment regimen. Prevention is, therefore, the best defence, explains Dr Weng.

Get Checked Sooner for Early Detection of Kidney Problems

Regular health screenings and a healthy lifestyle are keys to preventing kidney failure — almost half of those with diabetes are not aware of their condition and are not treated. In 2014, around 440,000 Singapore residents aged 18 years and above were diagnosed to have diabetes.

“If you have diabetes or high blood pressure, it is important to control your blood sugar and blood pressure to delay kidney failure,” says Dr Weng. Over the long term, high blood sugar levels and high blood pressure can damage the tiny vessels in the kidneys, reducing their ability to filter blood. If you are overweight, you should adopt a healthier lifestyle and lose weight, Dr Weng advises. This means eating healthily, reducing salt intake, and limiting protein and fat intake.

The article "When Your Kidneys Fail” was first published in Lifewise Magazine, Mar/Apr 2017.

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