KUALA LUMPUR: A think tank today warned that the country was on the brink of a nationwide kidney disease crisis, with at least 15.5 per cent or more than five million of the Malaysian population currently living with chronic kidney disease (CKD).
The Galen Centre for Health & Social Policy chief executive Azrul Mohd Khalib said the Health Ministry has projected that more than 106,000 Malaysians could be on dialysis by 2040 if the rising rates of kidney failure do not change.
"Malaysia needs a reality check and a renewed commitment to implementing existing kidney health strategies and policies. The country is on the brink of a nationwide kidney disease crisis," he said in a statement in conjunction with World Kidney Day today.
"The incidence and prevalence of patients with end-stage renal disease (ESRD) has been on an upward trend for the past 20 years. More than 51,000 people in Malaysia currently live with ESRD, needing kidney replacement therapy.
"Our incidence rate for ESRD is among the highest in the world.
"Each year, more than 10,000 people are newly diagnosed as needing dialysis and this annual number is steadily increasing. More than half had diabetes."
Azrul added the prevalence of chronic kidney disease is rising in tandem with the rate of diabetes.
"By next year, seven million adult Malaysians are estimated to live with Type 2 diabetes. It is already the highest in the Western Pacific region. Diabetics are 3.5 times more likely to develop CKD. We need to address the diabetes epidemic in Malaysia to respond effectively to chronic kidney disease."
He said during there were increasing calls for more haemodialysis (HD) centres to be built in constituencies and for more treatment subsidies or coverage to be provided to more people.
"The government is already bearing at least half of the expenditure used to treat chronic kidney disease. It is not sustainable," said Azrul.
"In 2010, the government spent RM572 million to treat ESRD. Today, Malaysia spends about RM3.3 billion on CKD and ESRD care annually. The Social Security Organisation spent RM334.67mil on dialysis treatments for its contributors in 2022, and receives up to 3,000 new treatment applications annually.
"There is a reason why more and more private haemodialysis centres are being set up. It is a booming business, as more people are becoming ill, needing to access dialysis care to survive."
Azrul said prevention and early detection continue to be sound and effective strategies.
"We need to do better to reduce Type 2 diabetes and increase awareness of kidney health. Individuals who are living with hypertension and diabetes, are at high risk of CKD and should be screened to increase the possibility of treating kidney disease much earlier.
"One of its key recommendations (of the National Action Plan for Healthy Kidneys (ACT-KID) 2018 - 2025) is to increase home-based dialysis therapy, namely peritoneal dialysis (PD). PD, compared to haemodialysis, provides many advantages including fewer dietary restrictions, takes between 30-40 minutes), opportunities to return to employment, preserving residual kidney function, less costly, and better patient survival."
"However, in 2022, the number of patients on peritoneal dialysis was 5,784 compared to 43,663 patients on HD. This must change. Clinicians must do their part to recommend to patients needing dialysis to take up peritoneal as the first option, while reserving HD as a second choice," he emphasised.
He also called for equitable access to kidney disease screening, emphasis on early diagnosis, and sustainable access to quality treatment to prevent chronic kidney disease or its progression.