The ESRD crisis in Singapore

In Singapore – where the crude incidence rate of late-stage chronic kidney disease has been rising – there are more people in the country, who must be especially concerned about maintaining social distancing. This is a particular conundrum for ESRD patients, who need to visit dialysis centres for treatment.

The COVID-19 pandemic is an unprecedented global emergency that – at the time of writing – has infected over 40 million people worldwide and claimed the lives of over a million people. Even though primarily regarded as a respiratory virus, more evidence is emerging that COVID-19 can affect multiple organs in the body, especially the immune and haematologic systems. This makes it even more dangerous to patients suffering from chronic diseases, particularly end-stage renal disease (ESRD) sufferers, who can be considered immunocompromised and may have multiple comorbidities.

In Singapore – where the crude incidence rate of late-stage chronic kidney disease has been rising – there are more people in the country, who must be especially concerned about maintaining social distancing. This is a particular conundrum for ESRD patients, who need to visit dialysis centres for treatment.

Dangerous to ESRD patients

When transmitted, the COVID-19 coronavirus enters the body through the respiratory system and begins to attack the lungs. From there, if not treated, it can attack other organs such as the kidneys, evidenced by a US study that found nearly a third of COVID-19 patients in intensive care developed acute kidney injury (AKI), with 15 per cent of those requiring dialysis.

Also, existing AKI sufferers who contracted COVID-19 were reported as being five times more likely to die from the virus – placing ESRD patients firmly in the ‘at-risk group’ as AKI frequently leads to ESRD. It therefore comes as little surprise that dialysis machines are as high in demand at hospitals as ventilator machines. This is because kidney failure incidences and AKI in COVID-19 patients are soaring – with an estimated 20 to 40 per cent of ICU patients in the US needing emergency dialysis.