New treatments can slow progress of kidney disease, delay need for dialysis

Early disease detection, lifestyle changes such as exercising also help, say doctors

- Salma Khalik

There are new treatments that can significantly slow down the progression of kidney disease, giving hope to the hundreds of thousands of people in Singapore suffering from early-stage kidney disease.

This is especially since the class of drugs called sodium glucose cotransporter-2 (SGLT2) inhibitors was placed on the standard drug list in November 2023, meaning it has become subsidised. It had been on the Medication Assistance Fund for the past two years, but that provides subsidies only for patients who have been means-tested.

SGLT2 inhibitors can slow down the progression of kidney failure by 37 per cent, said Dr Chua Horng Ruey, an expert in kidney disease at the National University Hospital (NUH).

While such drugs had originally been marketed as medication for diabetes, they have since been proven effective in slowing down the deterioration of kidney function in both people with and without diabetes.

Dr Chua, who heads the division of nephrology, or kidney disease, at NUH, said there is now "a wealth of more advanced therapeutics to treat chronic kidney disease, and especially diabetic kidney disease".

He said that if SGLT2 treatment is started in the early stage of kidney disease, when kidney function is still good, it might add 20 more years of kidney function versus without medication. If treatment is started later, when the disease is more advanced, it could still delay the need for dialysis by a couple more years.

How long it takes for someone to progress from stage 1 to 5 can vary significantly, from a few years to two decades or more.