SINGAPORE: More than 200,000 residents in Singapore were newly detected over a span of four years as showing signs of impaired kidney function – with a 1,000-odd Healthier SG clinics outside the public healthcare sector now tapped to monitor and care for these patients.
This move by the Ministry of Health (MOH) would hopefully prevent their condition from worsening and a potential surge in the country’s dialysis burden.
Among Singapore residents aged between 18 and 74, the age-standardised prevalence of those who have chronic kidney disease (CKD) has increased to 13.9 per cent in the period of 2023 to 2024.
This is nearly 60 per cent higher than that of 8.7 per cent for 2019 to 2020, according to the latest National Population Health Survey (NPHS) released by MOH in October 2025.
Survey respondents had their blood and urine samples collected and analysed.
Health Minister Ong Ye Kung said in March 2026 that despite the prevalence of diabetes and high blood pressure staying broadly stable, the absolute numbers of people with CKD and requiring dialysis continued to rise as more Singaporeans are older and more susceptible to CKD.
CKD refers to the long-term condition of irreversible damage to the kidneys with a gradual loss of their filtering ability.
CKD is usually brought about by risk factors such as hypertension (high blood pressure) and diabetes.
There are five stages of CKD. Dr Jason Choo, medical director of the National Kidney Foundation (NKF), said stage 1 means there is some kidney damage, such as the presence of protein in the urine, but the organ is still functional.
Stage 5 refers to End Stage Renal Disease (ESRD), also known as kidney failure, where dialysis or kidney transplantation may be required.
Since 2017, MOH has implemented the Holistic Approach in Lowering and Tracking Chronic Kidney Disease (HALT-CKD) programme across all public healthcare institutions (PHIs), with an aim to retard the progression of CKD.
Preventive efforts have since expanded to private healthcare, with MOH roping general practitioners (GPs) in the Healthier SG programme to care for patients with CKD. As of February 2026, there were about 1,100 Healthier SG clinics.
MOH implemented a care protocol for these GPs in January 2025 to provide guidance.
Dr Jonathan Yeo, a director of Family Medicine Clinic Chinatown, said the care protocol aided GPs to manage patients with mild and moderate CKD, and appropriately refer more complex cases to kidney specialists.
The senior family physician has been co-chairing the Healthier SG Care Protocols Sub-Workgroup since July 2023, which oversaw and facilitated the drafting and refinement of various Healthier SG care protocols.
Prior to the launch of the CKD care protocol, there were local guidelines on CKD care, and all three polyclinic clusters had their own set of guidelines.
What the care protocol did was to consolidate the key approaches and principles, thereby providing GPs with a uniform approach of managing those with CKD, said Dr Yeo.
Nearly 60 per cent increase highlighted potential strain on healthcare system
The increase in CKD prevalence was “not statistically significant”, stated MOH in the NPHS report.
Nonetheless, NKF’s Dr Choo was of the view that this was still important from a public health perspective, as it highlighted the potential strain on the healthcare system if there were more cases which progressed to advanced disease if their CKD was not detected or well-managed.
He said the increase in prevalence translated to about 200,000 residents aged between 18 and 74 newly diagnosed with CKD, bringing the total to an estimated 500,000.
The actual health burden is likely higher as those who are older face a higher CKD risk, but they are not covered under the scope of NPHS, added Dr Choo.
He noted that even if a small proportion, say 5 per cent, of these 500,000 patients eventually require dialysis following kidney failure, this would amount to about 25,000 new patients – more than double the current 10,000 patients on dialysis in Singapore.
In light of the latest NPHS results, MOH was asked by The Straits Times to comment on the effectiveness of HALT-CKD in retarding patients’ progress of CKD.
MOH said in its reply: “As the implementation of CKD care through Healthier SG GPs started recently in 2025, MOH will continue to review its effectiveness and progress over the next few years.”
Efforts in place to tackle growing health concern
Efforts have been implemented to tackle the risk factors of CKD, such as diabetes and hypertension, including through upstream measures of promoting healthier lifestyles and diets, said Senior Minister of State for Health Tan Kiat How in November 2025 at the opening of a SATA CommHealth dialysis centre in Fernvale.
Describing CKD as a “growing health concern” in Singapore, he noted that CKD, like many chronic conditions, progresses silently and can occur concurrently with other chronic conditions.
“This makes early detection and management critical, which is why under Healthier SG, an annual kidney assessment is mandatory as part of recommended care” for those with diabetes and hypertension, said Tan.
In its reply to ST, MOH said as of March 2024, HALT-CKD has enrolled more than 110,000 patients with CKD in the polyclinics and PHIs.
More than 80 per cent of the patients have been prescribed kidney protective medications, including newer drugs such as sodium-glucose cotransporter-2 inhibitors which have been shown to prevent a decline in kidney function.
Patients are also monitored for their blood glucose control because poorly controlled diabetes is a risk factor for disease progression to ESRD.
Other risk factors, such as smoking and co-morbidities like hypertension, are monitored and managed too.
The NPHS results showed that the prevalence of CKD among those with both diabetes and hypertension was at 47.4 per cent – higher than that of those with only diabetes (34.4 per cent), with only hypertension (21.4 per cent), and those without either of the chronic diseases (6.3 per cent).
Both Dr Choo and Dr Yeo similarly emphasised the importance of early detection and regular monitoring.
On this front, NKF has worked on kidney screening in the community. To date, more than 200 GP clinics have screened more than 9,000 at-risk individuals, with around one in seven requiring further follow-up.
Dr Yeo raised an example of how patients tend to view each chronic condition as a standalone condition, and fail to appreciate that poor blood sugar or high pressure control will insidiously weaken their kidney function.
“By the time they realise their kidneys had been significantly weakened, the damage was no longer reversible.”
He also said many people have a preconceived notion that there must be “pain in the kidneys or the back” to signify deteriorating kidney function or a kidney problem.
However, CKD is largely asymptomatic until the patient reaches end-stage kidney failure or stage 5, hence the mentality of “no symptoms means I must be healthy” is erroneous, said Dr Yeo. - The Straits Times/ANN
