Thursday 31 March 2016

NKF to build $12m mega dialysis centre in Jurong; Newest dialysis centre in Jurong West offers nocturnal dialysis

It will offer 24-hour dialysis, boosting access for patients and easing load of other centres
By Linette Lai, The Straits Times, 30 Mar 2016

To cope with rapidly rising kidney failure numbers here, the National Kidney Foundation (NKF) is building its largest dialysis centre - a $12 million complex in Jurong with 24-hour dialysis, dedicated to kidney care.

The new facility, 10 times the size of regular centres, is expected to have 200 dialysis stations and will cater to 2,000 patients a week, taking the load off the foundation's 29 other centres - particularly those in the west that are nearly full.

Adding a night dialysis slot enables centres to expand capacity, and also makes going for dialysis more convenient for patients with busy day jobs.

NKF is the main dialysis provider here, and nearly all of its 3,800 or so patients have high blood pressure, while three-quarters have diabetes. Both conditions are on the rise in Singapore, and are also leading causes of kidney failure here.

According to the latest Singapore Renal Registry Report, there were 5,521 people on dialysis in 2013, up from 5,244 the year before. It is the only option apart from a transplant, and patients must undergo the procedure for life.

Apart from dialysis, the Corporation Road complex, likely to open in phases starting next year, will teach patients how to carry out peritoneal dialysis - a special form of dialysis that can be done at home.

Plans for the centre were announced by Deputy Prime Minister Tharman Shanmugaratnam yesterday, at the opening of the NKF's first 24-hour dialysis centre in Jurong West, which gives patients more flexibility to choose when they want treatment.

Of the yet-to-open facility, he said it "will greatly expand access to subsidised haemodialysis services to the renal patients in the western region".

He noted, too, that NKF must go beyond offering dialysis services and tackle the problem at its root, through better education and prevention programmes to curb the onset of kidney diseases.

Peritoneal dialysis, which is more convenient and just as effective as dialysis done in the centres, is not common in Singapore, according to NKF chief executive Edmund Kwok, and the new centre will try to change that.

"One of the reasons that people have shied away from it is that they are not very confident they can do it themselves," he said.

"Those who are not very sure, you can come to the (new) centre and we will train you for as long as you need. As you get better, more independent, you will be able to do it yourself."

A third of the funding for the new centre will come from the Sirivadhanabhakdi Foundation, which is based in Thailand and supports medical, religious and educational causes.

The centre will also focus on preventing kidney failure.

"We must redouble our efforts on preventive care," Mr Tharman said. "One in nine adult Singaporeans has diabetes, and the number is growing."

The opening of the NKF Dialysis Centre, supported by the Sirivadhanabhakdi Foundation, was graced by Deputy Prime Minister Tharman Shanmugaratnam on 29 March 2016.
Posted by NKF Singapore on Thursday, March 31, 2016

NKF introduces night dialysis for kidney patients
By Linette Lai, The Straits Times, 30 Mar 2016

Kidney dialysis sessions at night - a first here - mean patients can continue to work during the day.

For people such as dance choreographer Manimaran Thorasamy, who has been undergoing dialysis after 10pm at the National Kidney Foundation's (NKF) newest centre in Jurong West for the past week, this is a godsend. The centre is the first to offer a night shift for dialysis patients.

Mr Manimaran, 55, who also teaches Indian classical and folk dance in schools, said his earlier thrice-weekly evening dialysis sessions used to interfere with his classes.

"People like me, we are very busy in the day," he said. "I have classes in the afternoon and evening, so I prefer doing dialysis at night."

Unlike normal dialysis, which lasts around four hours, night-time dialysis takes between six and eight hours. At the new Jurong West centre, which was officially opened yesterday, the night shift starts at 10pm and ends at 6am.

"The chairs are comfortable," Mr Manimaran said. "At night, when dialysis starts, I just relax and go to sleep."

The centre was opened with a $2.2 million donation from the Sirivadhanabhakdi Foundation in Thailand, the first foreign foundation to provide sponsorship to the NKF.

Deputy Prime Minister Tharman Shanmugaratnam, who spoke at the opening ceremony, stressed the important role that organisations both public and private can play in giving back to society.

He raised the example of how the Singapore Contractors Association raised $900,000 for a new dialysis centre in Yishun, and the Yuhua Citizens' Consultative Committee and its residents raised $1.2 million for another centre in Jurong East.

"It is heartening to see individuals, the private sector and philanthropic foundations giving to the society," Mr Tharman said.

Apart from being able to better accommodate patients' work demands, having longer dialysis sessions at night is also easier on patients' bodies.

Patients on nocturnal dialysis are allowed a less restrictive diet and generally need less medication.

"It is gentler on the heart, so the risk of heart attacks is lower," said Mr Koh Poh Tiong, the NKF chairman. "It is also easier to control blood pressure."

He also said that adding a fourth dialysis slot - on top of the current morning, afternoon and evening shifts - means that the centre is able to take in more patients.

The new centre has space for 32 patients on the night shift.

"It is good because we are short of space," he said. "Every day in Singapore, there are five new cases of kidney failure."

* Night dialysis: Staying overnight for dialysis and better for it
Patients say they feel much better and have time for work, family
By Janice Tai, Social Affairs Correspondent, The Sunday Times, 23 Jul 2017

They turn up dressed in loose and comfortable clothing, and drape blankets over themselves as they lean back in easy chairs.

Not long after the lights are dimmed at 11pm, light snoring can be heard wafting from various corners of the room.

A midnight movie screening?

No, this is the scene playing out at kidney dialysis centres in Jurong West and Hougang every night. The two centres operate every day round the clock.

A group of 20 patients have been receiving nocturnal dialysis treatment at the two centres thrice a week, but on different days.

Singapore's largest provider of kidney dialysis treatment - the National Kidney Foundation (NKF) - became the first and only operator here to offer patients the option of night dialysis last year. NKF runs 31 dialysis centres islandwide.

The arrangement has benefited both patients and the NKF.

The NKF has not been able to keep up with the rising number of kidney patients. Every day, there are five new cases of kidney failure, and those who need dialysis topped 6,200 in 2015. NKF currently serves two in three of these patients and it plans to open five more centres by next year.

Since May, the charity has been forced to subsidise new patients to receive dialysis at private centres because all their facilities are full.

Nocturnal dialysis has helped lighten the load at the NKF centres.

More importantly, NKF said research shows that night dialysis results in better health outcomes for some patients, compared with those who go for it during the day.

Nocturnal dialysis lasts about seven hours compared with the four-hour sessions done during regular hours, which is 7am to 11pm. The longer hours mean that toxic waste and fluids are removed at a slower rate and this puts less stress on the heart.

Day sessions tend to be shorter because NKF has to accommodate three different batches of patients who come in during three time slots during the day.

"Nocturnal dialysis with longer dialysis hours also allows for the removal of some of the bigger-sized toxins that are not removed efficiently by the usual dialysis," said Dr Mooppil Nandakumar, NKF's medical director.

Countries such as Canada and the United States have been doing nocturnal dialysis for several years.

A 2010 research paper on patients who received night dialysis in North America, for instance, found that they were hospitalised less, gained more weight and had lower blood pressure compared with their peers who received dialysis during shorter daytime sessions.

Besides better health outcomes and survival rates, night dialysis enables patients to work and spend more time with their families during the day.

Taxi driver Chew Boon Seong, 52, has been able to drive for longer hours because he no longer needs to make time for dialysis sessions during the day.

"I feel more energetic now. So I can drive from 7.30am to 8pm every day. My income has doubled and I have better appetite now," said Mr Chew, who goes to the Jurong West centre for night dialysis thrice a week.

Patients on nocturnal dialysis are allowed a less restrictive diet and generally need less medication.

The two centres have room for a total of 70 patients during the night shift. NKF said that the take-up rate for night dialysis has been middling because many people still prefer to sleep in their own beds.

"More than half of our patients are aged 60 and above and they are afraid to change their existing lifestyles of sleeping in their own homes," said Dr Nandakumar.

"But patients who do night dialysis have told us that they feel much better and are able to work longer hours now. We hope to help patients to achieve better clinical outcomes for a better quality of life."

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