Kidney failure on the rise in Malaysia

Dr-Jeyaindran-SinnaduraiPETALING JAYA: They call it a silent disease and it strikes nine out of every 100 Malaysians.

There are currently between two and three million Malaysians suffering from chronic kidney disease (CKD) and the numbers are expected to rise, reported the Sunday Star.

CKD has five stages and the signs are not obvious in the beginning. Most patients in stage five, known as end stage renal disease or kidney failure, depend on dialysis to carry on with life.

Currently, there are 40,000 dialysis patients. Based on a recent study, the number is projected to more than double to 106,249 in 2040 if no effective remedies are put in place.

According to the study titled “Forecasting the Incidence and Prevalence of Patients with End-Stage Renal Disease in Malaysia up to the Year 2040” Malaysia is the top seventh country with the highest dialysis treatment rate in the world.

The holy grail for many kidney patients is a kidney transplant. In fact, most of the 20,000 people on the organ transplant waiting list are in need of kidneys.

However, while organ pledges remain low, the number of medical professionals, including surgeons and supporting staff, that can conduct transplants are less than ideal.

The health ministry said there were plans to increase the number of medical staff to conduct more kidney transplants.

“Increasing the capacity of medical staff to improve the level of transplants is the ideal solution,” said Health Ministry deputy director-general Dr Jeyaindran Sinnadurai.

“In the long run, kidney transplants will become cheaper compared to dialysis,” he told the Sunday Star.

He said the main challenge when it came to transplants was the need to increase the number of specialists, including transplant surgeons, pathologists and other supporting medical professionals.

Jeyaindran said the ministry was looking into roping in foreign and local experts to train more specialists so that more transplants could be conducted.

Jeyaindran said the “greatest gift” a person could offer was his or her organs for a transplant. However, he said only 1% of the Malaysian population were organ donors.

“As such, we need to strengthen the mechanism to support such a ‘gift of life’ to another in need,” he told the Sunday Star.

Hence, he said, the need to double the number of “organ retrieval” teams. Currently, there are only two such dedicated teams – one in Hospital Kuala Lumpur (HKL) and another in Selayang Hospital.

Jeyaindran said transplants could also be done involving living donors, who were often family members of the patient.

However, for cases where the organ is from an unrelated deceased donor or cadaveric donor, there was the problem of compatibility with the patient.

On the issue of dialysis treatment, Jeyaindran said the ministry was focusing more on peritoneal dialysis which involved the lining of the body’s abdomen with a solution to clean the patient’s blood.

“Peritoneal dialysis can be done in the comfort of a patient’s own home. It is convenient and there is no need for patients to go to a hospital or dialysis centre like in hemodialysis treatments,” he said.

In his Budget 2014 speech, Prime Minister Najib Razak announced the government’s initiative to promote peritoneal dialysis by providing free Continuous Ambulatory Peritoneal Dialysis (CAPD) kits costing RM19,000 per unit.

The initiative benefited over 1,000 patients who now use the kit at home.

Malaysian Society of Nephrology council member Dr Lily Mushahar concurred that cases of CKD were on the rise, and attributed the spike to the increase in the elderly population in Malaysia.

She said with better healthcare in Malaysia, the population now had a longer life expectancy and this had led to an increase in non-communicable diseases (NCDs) such as hypertension and diabetes which were related to long-term complications like kidney disease.

“The rise in NCDs over the last two decades, especially diabetes and hypertension, has led to the corresponding hike in kidney failure,” she said.

Another factor, she said, was the lack of awareness among Malaysians, as many did not go for regular medical screening.