Chronic kidney disease: What you need to know and how to manage it

Over the past 50 years, Singapore has made great strides on the social and economic fronts. But this progress can be a double-edged sword when it comes to population health.

According to Dr Kwek Jia Liang, a senior consultant in the department of renal medicine at Singapore General Hospital, the socioeconomic climate in Singapore has contributed to a raft of health concerns, such as the prevalence of Type 2 diabetes.

“Facets of modern living, including the consumption of processed and energy-dense foods as well as the adoption of sedentary lifestyles, have led to an uptick in obesity,” he said.

Coupled with an aging population, this has resulted in a rise in the number of people with Type 2 diabetes locally, the healthcare expert said.

THE LINK BETWEEN DIABETES AND CHRONIC KIDNEY DISEASE

In 2021, the International Diabetes Federation found that Singapore has a high incidence of Type 2 diabetes, with an age-adjusted prevalence of 11.6 per cent – surpassing the global average of 9.8 per cent, shared Dr Kwek. 

The dangers associated with this are not just limited to its debilitating symptoms such as excessive thirst and urination; those afflicted with Type 2 diabetes also have a higher risk of developing chronic kidney disease. 

Chronic kidney disease is a long-term disease that may lead to kidney failure, and is incurable. Individuals with early onset of the disease are often asymptomatic. According to Dr Kwek, diabetes is the most common cause, accounting for two out of three cases of kidney failure.

Individuals who are at risk of Type 2 diabetes and chronic kidney disease often share similar traits, such as being older adults or having a family history of either disease, Dr Kwek observed. 

“Besides diabetes, other ailments like hypertension, cardiovascular disease and chronic glomerulonephritis are also commonly linked to the development of chronic kidney disease,” he added. 

AN OVERVIEW OF CHRONIC KIDNEY DISEASE MANAGEMENT

Identifying and controlling underlying medical conditions, such as Type 2 diabetes and hypertension, are key to better managing chronic kidney disease, said Dr Kwek.

“Additionally, regular screenings for at-risk individuals will enable timely detection of chronic kidney disease and facilitate treatment at its earlier stages,” he shared.

Besides early detection, there are classes of medication that can help slow down the progression of chronic kidney disease. “These include certain blood pressure medication and diabetic medication,” said Dr Kwek, who added that individual results may vary.

He cautioned: “It is also important for chronic kidney disease patients to avoid medication that can be toxic to the kidney. One example is the long-term use of painkillers, such as  nonsteroidal anti-inflammatory agents and cyclooxygenase-2 inhibitors. Patients should always inform any medical practitioners new to them about their underlying condition.” 

EAT AND LIVE WELL

A large part of managing chronic kidney disease and its risks involves maintaining a healthy lifestyle.

“Weight control, smoking cessation and avoiding a sedentary lifestyle are some habits individuals with chronic kidney disease can adopt to slow its progression,” said Dr Kwek. 

According to the doctor, protein intake is among the more delicate nutritional considerations to keep in mind when managing chronic kidney disease. How much protein one should take depends on the individual’s stage of chronic kidney disease progression, nutritional status as well as diabetic control.

“A high-protein load may stress the kidneys, generating more toxins, phosphates and acids for the kidneys to clear,” he explained. 

In general, Dr Kwek advises that individuals maintain a protein intake of between 0.6g and 0.8g per kilogram body weight daily, depending on a patient’s comorbidities.

The type of protein in one’s diet matters, too. “In a large Singapore study, it was found that red meat intake may increase the risk of kidney failure in the general population, and substituting it with alternative protein sources may reduce that risk,” said Dr Kwek.  

On the flip side, for malnourished individuals with chronic kidney disease, an appropriate amount of protein is required to improve one’s overall nutrition. Said Dr Kwek: “Sometimes, oral nutritional supplements may be appropriate for individuals with chronic kidney disease who are unable to obtain all the required nutrition through their usual diet.” 

Whatever the case, it is key that at-risk individuals and patients take proactive measures to fight chronic kidney disease – with the first step being to consult a trusted healthcare professional. 

Make an appointment with your physician today to learn more about your chronic kidney disease risk and how to manage it.

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