Materia Medica Malaysiana

Renal failure cases on the rise

There is also a dramatic increase in the intake of new dialysis patients during the same 24-year period — from 43 in 1980 to 2,400, adding to the almost 10,000 who had already registered. Nephrologists believe that the number registered may not reflect the actual situation in the country as there could be many suffering in silence due to lack of facilities. Some could also have resorted to traditional or alternative treatment.

It is estimated that There are some about 100 new end-stage renal cases per million population every year. This, however, is a conservative estimate and believed to be "under-provided" as no proper survey has been undertaken thus far. According to National Kidney Foundation of Malaysia (NKF) medical director Dr T. Thiruventhiran, these figures were growing in tandem with the rise in the number of diabetics and hypertension patients — two major contributors to chronic kidney disease.

In Malaysia, he said, the most common cause of kidney disease was diabetes mellitus. About one-third of patients suffering from diabetes mellitus will go on to develop kidney failure.

He added that about 50 per cent of advanced kidney failures were due to diabetes mellitus. Other causes of kidney failures are high blood pressure, stones in the kidney, abuse of painkillers, infections and reflux diseases in children, Dr Thiruventhiran said early detection of kidney disease can prevent progression to kidney failure.

In view of the rising trend, the NKF is now on an aggressive campaign to create awareness of among Malaysians on kidney diseases, its causes and prevention.

NKF Board of Managers vice-chairman Datuk Dr Zaki Morad Mohd Zaher said with the increase in diabetics, the number kidney disease cases was also expected to increase correspondingly. The ageing population is another contributory factor to the high incidence of kidney cases.

According to the World Health Organisation, Southeast Asia will have the highest rate of increase in diabetics, from 35 million in 2000 to 80 million in 2025.

Currently, More than eight per cent of Malaysian adults suffer from diabetes. And by 2010, this figure is expected to reach 12 per cent.

Dr Zaki, a consultant nephrologist with the Ministry of Health, said when more people suffered from the disease, it would be a burden on the country's resources. In the United States, it costs about US$15 billion (RM57 billion) a year to treat kidney patients. In Malaysia, he said, the Government spent more than RM1 million annually to directly or indirectly provide dialysis treatment to kidney patients.

"Many of these patients now live longer because of good and affordable treatment provided by government hospitals, non-governmental organisations, social security organisations and private centres. The Government is also now focused on managing diabetic and hypertension patients well." About 40 per cent of patients receive dialysis treatment dialysed in the Government's 81 centres, 35 per cent in 73 centres run by NGOs and 25 per cent in 76 private dialysis centres. Death rates of patients undergoing haemodalysis have remained at 10 per cent or lower a year for the last 24 years. Continuous Ambulotory Peritonea Dialysis (CAPD) death rates were higher at 10 to 20 per cent.

On renal transplants, Dr Zaki said the number of people coming only about 25 donors, or 1.2 per million population, come forward to donate their kidneys was still small.

"This number is very small compared to the number of people waiting for renal transplants.

"If we can get more people to donate their kidneys, then there will be fewer people on dialysis." he added.

Dr Zaki said their main concern now was to prevent kidney failure among Malaysians because if the number was big it would be an additional tax burden on the country's coffers. He also advised those in the high-risk group to go for regular screening to detect kidney diseases early.

Malaysia's youngest kidney victim is an eight-year-old. And the average survival period of a kidney patient is between eight and 10 years. Meanwhile, NKF Public Education Unit programme adviser P. Sarada Devi said brochures on kidney diseases were available at all their outlets nationwide. She said talks, exhibitions and public forums were also held from time to time. For details call Sarada at Tel: 03-7954-9048 or nkf website: www.nkf.org.my