THE numbers speak for themselves. Chronic kidney disease (CKD) is a burden that may overwhelm Malaysian healthcare in the years to come.
In 2022, there were 51,000 Malaysians already on dialysis due to end-stage kidney failure, according to the Malaysian Dialysis and Transplant Registry Report. In addition, 9,500 new dialysis cases are also recorded in the country every year.
The Health Ministry has estimated that more than 106,000 Malaysians could be on dialysis by 2040.
Data indicates that CKD affects about 15 per cent of the population in Malaysia, says Pantai Hospital Kuala Lumpur consultant nephrologist and physician Dr Wong Mun Hoe.
Unfortunately, in its early stages, CKD doesn't exhibit any obvious symptoms, leading to many patients assuming that their health is fine.
"The kidney is a unique organ. It will try its best to compensate and function until it can no longer do so. Much like a car engine, but when it finally breaks down, nothing works," explains Dr Wong.
As a result, by the time patients seek treatment, their kidneys are already functioning at a poor level. These patients usually see a doctor complaining of symptoms such as a swollen face or leg, vomiting or poor appetite, but are unaware that they have CKD.
"CKD progresses with time until it becomes really bad. Screening is the best way to detect and manage this condition because there are no symptoms in the early stages."
CHECK AND SCREEN
Screening is done via a blood and urine test, and those at risk should be screened regularly, adds Dr Wong.
The high-risk groups include those with either diabetes or hypertension or both of the conditions.
In fact, 90 per cent of CKD cases can be attributed to diabetes and hypertension, says Dr Wong.
"With one in four Malaysians being hypertensive and one in five having diabetes, these are risk factors that cannot be taken lightly. How many of these people will go on to have CKD?"
CKD can be divided into five stages, and by the time patients reach stage five, it is already too late to do anything for them. Both their kidneys would no longer be functioning and their only options would be either dialysis or a kidney transplant.
Dr Wong says with accurate assessments, doctors today can predict your risk of kidney failure should you have CKD.
"We have advanced from just telling patients at what stage their CKD is, to predicting their risk for kidney failure. At the same time, we should advise them on what they can do about it."
The purpose of screening is to inform patients about their health status, he adds and subsequently, to tell them how to manage the condition and halt its progress.
"The purpose of screening is to pick it up early and intervene early so less people end up going on dialysis."
There are now many ways to slow down kidney failure in CKD patients, says Dr Wong, but they should not wait until end-stage kidney failure before seeking treatment.
Unfortunately, there is a tendency for patients to react in disbelief when told they have CKD, especially if they are not displaying any symptoms.
This results in them seeking alternative treatment or therapies and turning to supplements or traditional medicine in the hope of a cure.
Dr Wong says there is no cure at the moment for end-stage kidney failure. It cannot be reversed with medication or any kind of treatment.
The fact that Malaysia is going to be an ageing population soon also ups the risk.
The risk of CKD increases with age, so the older you are the higher the risk.
However, if you're also ageing with diabetes and hypertension, this risk increases significantly. It will accelerate the process.
Studies also indicate that those who were exposed to Covid-19 have a higher risk of CKD, says Dr Wong.
This is especially so if the kidneys were impacted by the infection. These people will face a higher risk of CKD in the years to come.
KIDNEY HEALTH
*Quit smoking/reduce or stop alcohol consumption - a healthier lifestyle leads to healthy kidneys.
*Eat right - a balanced diet in appropriate portions.
*Exercise - at least 30 minutes a day.
*Consume enough water - eight glasses a day is generally recommended.
*Keep diabetes/hypertension in control - once diagnosed, discuss management options with your doctor.
*Get screened for chronic kidney disease - know your stage and initiate treatment plans.