According to recent statistics by National Kidney Foundation (NKF), about 5.7 new patients are diagnosed with end-stage kidney disease (ESKD) daily and there are currently more than 8,500 people in Singapore requiring dialysis.

These numbers are expected to rise with an ageing population.

It is important for patients who are diagnosed with ESKD to plan ahead for dialysis or get a kidney transplant.

Some may choose not to pursue either option if they feel that dialysis may not extend their life or improve their quality of life. These patients are usually managed by palliative physicians and nephrologists.

Kidney dialysis is a process to remove waste products and excess fluid from the blood when the kidneys fail. There are two main forms of dialysis:

  1. Haemodialysis and

  2. Peritoneal dialysis

Haemodialysis is more common and the one most people are aware of. During the procedure, blood is passed from the blood vessels in your arm to the dialysis machine which filters out waste products and removes excess fluid before returning it to your body via another needle. This is usually done at a dialysis center 3 times a week for 4 hours each session.

Peritoneal dialysis uses the lining of your abdomen (the peritoneum) as a filter (instead of a machine!). The peritoneum contains many small blood vessels which makes it a useful filtering device. A dialysis catheter, in the form of a thin tube, needs to be inserted into the abdomen and is left there permanently.

Dialysis fluid enters the abdomen via the catheter and while in the abdomen excess fluid and waste products are removed from the bloodstream into the dialysis fluid. The used fluid is drained after a few hours and replaced with fresh fluid. This process can be done overnight via a machine while you are sleeping, or a couple of times during the day.

Peritoneal dialysis is a home-based treatment and can give patients and their caregivers some flexibility. Patients and their caregivers would be trained to do this dialysis themselves at home, and the training usually takes about 1 week.

In this 'Ask the Specialist' Q&A forum, Dr Lee Pei Shan, Associate Consultant from the Department of Renal Medicine at Sengkang General Hospital (SKH), answers your questions about end-stage kidney disease (ESKD) and dialysis. SKH is a member of the SingHealth group.

This Q&A forum is open from 15 June to 15 July 2022.


Click here to post your question


About Dr Lee Pei Shan

Dr Lee Pei Shan graduated from University College London. She completed both her residency training in Internal Medicine and Nephrology in SingHealth and was the chief resident during her junior and senior residency training.

Dr Lee is currently an associate consultant in the Department of Renal Medicine (General Medicine) at Sengkang General Hospital (SKH). She has a special interest in Peritoneal Dialysis (PD), a home-based dialysis, and is also currently the PD lead for SKH.

She believes in empowering patients to take charge of their own health. Additionally, she hopes to help patients with end-stage kidney disease (ESKD) on dialysis achieve a good quality of life despite having to live with a chronic medical condition that potentially can have profound implications on their mental and physical wellbeing.

Ref: J22