Global Perspectives in Dialysis: Singapore

Abstract

The first hemodialysis (HD) in Singapore was conducted in September 1961 for acute kidney failure with the twin-coil artificial kidney. It was not until 1968 when the chronic HD program was instituted (1). Since then, the incidence and prevalence of CKD stage 5 (CKD5) and dialysis have increased significantly. The Singapore Renal Registry is maintained by the National Registry of Diseases Office. On the basis of its Annual Report 2018, the crude incidence rate of CKD5 increased from 341.5 per million population (pmp) in 2009 to 504.1 pmp in 2017 (2). Although the age-standardized incidence rate (ASIR) of CKD5 remained stable (256.6–289.2 pmp), the ASIR of dialysis increased significantly from 159.0 pmp in 2009 to 187.0 pmp in 2018 (Table 1). Eighty percent of the new patients on dialysis were aged 50–79 years in 2018, supporting the notion that the greater incidence of dialysis was related to an aging population. However, the crude incidence rate of dialysis also increased significantly for those aged 30–39 and 40–49 years over a 10-year period, which could possibly be explained by the increase in incidence of diabetes. View this table: Table 1. Age-standardized incidence rate of CKD stage 5 and dialysis (2) The age-standardized prevalence rate of dialysis also increased from 890.6 pmp in 2009 to 1081.7 pmp in 2018 (2). The ASIR of HD was consistently higher compared with that of peritoneal dialysis (PD). Although the ASIR for HD remained relatively stable (2), the ASIR for PD increased significantly over the years (Figure 1). Similarly, the prevalence rates of HD were consistently higher than those of PD across the years. However, the increment in age-standardized prevalence rate for HD was higher than that of PD (2) (Figure 2). Figure 1. Incidence rate (per million population [pmp]) of dialysis by modality from 2009 to 2018. HD, hemodialysis; PD, peritoneal …