Chronic Kidney Disease Prevention in Singapore

Ramirez, Sylvia

doi:10.2215/cjn.03500807

Cited by 11 publications

(9 citation statements)

References 26 publications

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“…This is aimed to intervene prior to the onset of any evidence of kidney disease [10]. However, despite the existence of the program since 1997, the incidence of CKD is still increasing locally [2].…”

Section: Discussionmentioning

confidence: 99%

Limited knowledge of chronic kidney disease among primary care patients – a cross-sectional survey

et al. 2012

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BackgroundKidney disease is the 9th leading cause of death in Singapore. While preventive effects have focused on early detection and education, little is known about the knowledge level of chronic kidney disease (CKD) locally. We seek to evaluate the knowledge of CKD among primary care patients.MethodsWe conducted a cross-sectional survey of a convenience sample of 1520 patients from 3 primary care centers. Those with existing CKD or on dialysis were excluded. Knowledge was assessed based on 7 questions on CKD in the self-administered questionnaire. One point was given for each correct answer with a maximum of 7 points.Results1435 completed all 7 questions on CKD. Mean age was 48.9 ±15.0 (SD) years. 50.9% were male. 62.3% had a secondary and below education and 52.4% had a monthly household income of ≤ $2000. 43.7% had chronic diseases. Mean score was 3.44 ± 1.53 (out of a maximum of 7). Median score was 4. In multivariate logistic regression, being older {>60 years [Odds Ratio (OR) 0.50, 95% Confidence Interval (CI) 0.32-0.79]; 40–60 years (OR 0.62, 95% CI 0.43,0.89)}, less educated [up to primary education (OR 0.33, 95% CI 0.22-0.49)], having a lower monthly household income [

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Section: Discussionmentioning

confidence: 99%

Limited knowledge of chronic kidney disease among primary care patients – a cross-sectional survey

et al. 2012

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“…Population based screening for chronic kidney disease has been advocated by some, 4 15 16 and the National Kidney Foundation/Kidney Dialysis Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease have recommended screening for people at high risk of kidney disease, including those with diabetes and hypertension and aged over 60. 1 14 Given that considerable resources would be required to set up a population based screening programme, our results are important.…”

Section: Discussionmentioning

confidence: 99%

“…While clinical practice guidelines for chronic kidney disease from the National Kidney Foundation/Kidney Dialysis Outcomes Quality Initiative have recommended targeted screening of high risk patients, including those with diabetes or hypertension and aged >60, 1 14 others have suggested a population based approach. 4 15 16 The International Federation of Kidney Foundations recently surveyed its 28 member nations on the existence of screening programmes for chronic kidney disease, and 24 reported some form of screening activity. 17 While most programmes entailed screening for disease among high risk groups, including those with hypertension, diabetes, and a family history of chronic kidney disease and older people, a few countries, including Hong Kong, Japan, and the Netherlands, have active population based screening programmes.…”

Section: Introductionmentioning

confidence: 99%

Population based screening for chronic kidney disease: cost effectiveness study

Manns

Hemmelgarn²,

Tonelli³

et al. 2010

BMJ

135

128

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Objective To determine the cost effectiveness of one-off population based screening for chronic kidney disease based on estimated glomerular filtration rate.Design Cost utility analysis of screening with estimated glomerular filtration rate alone compared with no screening (with allowance for incidental finding of cases of chronic kidney disease). Analyses were stratified by age, diabetes, and the presence or absence of proteinuria. Scenario and sensitivity analyses, including probabilistic sensitivity analysis, were performed. Costs were estimated in all adults and in subgroups defined by age, diabetes, and hypertension.Setting Publicly funded Canadian healthcare system.Participants Large population based laboratory cohort used to estimate mortality rates and incidence of end stage renal disease for patients with chronic kidney disease over a five year follow-up period. Patients had not previously undergone assessment of glomerular filtration rate. Main outcome measures Lifetime costs, end stage renal disease, quality adjusted life years (QALYs) gained, and incremental cost per QALY gained.Results Compared with no screening, population based screening for chronic kidney disease was associated with an incremental cost of $C463 (Canadian dollars in 2009; equivalent to about £275, €308, US $382) and a gain of 0.0044 QALYs per patient overall, representing a cost per QALY gained of $C104 900. In a cohort of 100 000 people, screening for chronic kidney disease would be expected to reduce the number of people who develop end stage renal disease over their lifetime from 675 to 657. In subgroups of people with and without diabetes, the cost per QALY gained was $C22 600 and $C572 000, respectively. In a cohort of 100 000 people with diabetes, screening would be expected to reduce the number of people who develop end stage renal disease over their lifetime from 1796 to 1741. In people without diabetes with and without hypertension, the cost per QALY gained was $C334 000 and $C1 411 100, respectively.Conclusions Population based screening for chronic kidney disease with assessment of estimated glomerular filtration rate is not cost effective overall or in subgroups of people with hypertension or older people. Targeted screening of people with diabetes is associated with a cost per QALY that is similar to that accepted in other interventions funded by public healthcare systems.

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“…According to the Singapore renal registry, the mean age of new CKD patients increased from 56.3 years in 1999 to about 64 years, 2009 onwards 13. According to the data from Brunei registry, the mean age of dialysis patients was 57 ± 12.5 years and 45% of the patients were aged between 41 and 60 years 11.…”

mentioning

confidence: 99%

Aetiology, practice patterns and burden ofend‐stagekidney disease in South Asia andSouth‐EastAsia: A questionnaire‐based survey

et al. 2020

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Aim There is paucity of data on the epidemiology of end‐stage kidney disease (ESKD) from South Asia and South‐East Asia. The objective of this study was to assess the aetiology, practice patterns and disease burden and growth of ESKD in the region comparing the economies. Methods The national nephrology societies of the region; responded to the questionnaire; based on latest registries, acceptable community‐based studies and society perceptions. The countries in the region were classified into Group 1 (High|higher‐middle‐income) and Group 2 (lower|lowermiddle income). Student t‐test, Mann‐Whitney U test and Fisher's exact test were used for comparison. Results Fifteen countries provided the data. The average incidence of ESKD was estimated at 226.7 per million population (pmp), (Group 1 vs. Group 2, 305.8 vs. 167.8 pmp) and average prevalence at 940.8 pmp (Group 1 vs. Group 2, 1306 vs. 321 pmp). Group 1 countries had a higher incidence and prevalence of ESKD. Diabetes, hypertension and chronic glomerulonephritis were most common causes. The mean age in Group 2 was lower by a decade (Group 1 vs. Group 2—59.45 vs 47.7 years). Conclusion Haemodialysis was the most common kidney replacement therapy in both groups and conservative management of ESKD was the second commonest available treatment option within Group 2. The disease burden was expected to grow >20% in 50% of Group 1 countries and 78% of Group 2 countries along with the parallel growth in haemodialysis and peritoneal dialysis.

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Chronic Kidney Disease Prevention in Singapore

Cited by 11 publications

References 26 publications

Limited knowledge of chronic kidney disease among primary care patients – a cross-sectional survey

Limited knowledge of chronic kidney disease among primary care patients – a cross-sectional survey

Population based screening for chronic kidney disease: cost effectiveness study

Aetiology, practice patterns and burden ofend‐stagekidney disease in South Asia andSouth‐EastAsia: A questionnaire‐based survey

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