Caring for your kidneys
Who should go for kidney screening?
As the kidney weakens over time, toxins become harder to filter out and will accumulate in the body. Only then do overt symptoms appear. By that time, it may be stage five chronic kidney disease (CKD).
Diabetes, both Type 1 and Type 2, is the commonest cause of CKD in Singapore. Other causes include hypertension, inflammation and genetic factors.
As many people might not know they have CKD – owing to its silent symptoms – it is vital that individuals get their kidneys screened.
“I think a lot of times is because when you don’t feel sick, (you think) why should I go to see the doctor to do any health screening? The second thing is the fact that you feel it’s going to be somebody else, but not me. The third one is probably because a lot of people feel that they have no time.”
Dr Elly Sabrina Ismail, Family Physician, Banyan Clinic, who is all too aware of human inertia when it comes to health screening – and of the heartache when people find out about their kidney disease too late.
“Chronic kidney disease is like a frog in a beaker of water. When you ramp up the temperature gently, the frog will be able to adjust. Similarly, in patients with CKD, because it’s such a slow progression, the body has time to adjust until the toxin is actually very high. By then, it will be too late.”
Assoc Prof Tan Chieh Suai, Head and Senior Consultant, Department of Renal Medicine, Singapore General Hospital, who gives this analogy to his patients to explain why they are discovered late to have end stage kidney failure.
Kidney screening involves two simple tests which are key to detecting CKD. One is a simple blood test to detect creatinine, an indicator of toxin in the body, and would also tell if the kidneys are performing well. The other is a urine test to check for microscopic traces of blood or protein, which would indicate that the kidneys’ filtering function has been affected.
For individuals at higher risk of developing CKD, an annual kidney screening is particularly essential. The risk factors include:
- Pre-existing medical conditions such as diabetes, hypertension, obesity and/or heart disease.
- A family history of kidney disease, diabetes and/or hypertension.
It is recommended that you screen every year and do encourage your family members to go for screenings too. Talk to your family doctor for more information.
NKF runs a CKD intervention clinic, which provides free kidney screening for the at-risk and high-risk groups.
“What I can relate to is that my dad passed away because of kidney failure, and it happened right in front of my eyes. During that year when my dad passed away, I think that was the moment when you really think that, ‘Okay, enough is enough and you have to do something about it.’ … In fact, I’m so, so fortunate. Because of this early detection, I didn’t have to go through the hardship of dialysis and I basically just have to take the oral medicine daily after 20 years.”
Mr Fuad Aliman, 53, who was diagnosed with early kidney disease in his 30s when he went for a screening that showed a leakage of protein in his urine. He was able to control it with medication and lifestyle changes such as shedding 70 kilogrammes – half his weight – over the years by exercising, even running marathons and climbing mountains, which helped reduce stress on his kidneys.
