Comparing your treatment options
Lifestyle adjustments
Use this table to consider the factors that may help you choose a treatment:
| Your Kidneys, Your Plan |
Dialysis |
Kidney Supportive Care
(KSC / Conservative Management) |
Peritoneal Dialysis
(PD / Water Dialysis) |
Hemodialysis
(HD / Blood Dialysis) |
| Your treatment |
- Dialysis at home.
- Done daily.
|
- Dialysis at a centre.
- Done 3 times a week.
|
Medicine and monitoring by your medical team. |
| Getting Started |
You need a surgery to create an access point on your belly. |
You need a surgery to create an access point on your arm. |
No preparation. |
| Treatment process |
Clean dialysis fluid flows into your belly to remove toxins and fluids. |
An artificial dialysis filter in the HD machine cleans your blood. |
Manage your symptoms through diet and medicine. |
| Your suitability |
May not be suitable if you had a surgery in or around your belly. |
May not be suitable if you have a weak heart or poor blood vessels. |
More suitable for people aged 75 and above with multiple health conditions or limited life expectancy2. |
| Your treatment risks |
Chance of infection. You need to keep the access points clean. |
No treatment-related risks. |
| Your daily activities |
Flexible dialysis schedule. |
Fixed dialysis schedule. |
Take medicine as prescribed. |
| Your diet |
There are some food and fluid limitations. |
| Your travel plan |
You need to bring your PD equipment when you travel. |
You need to arrange to go to a dialysis centre for HD wherever you travel. Insurance may not cover overseas dialysis cost. |
You can travel if you feel well. |
| Your home |
You need to store the dialysis bags and a small dialysis machine at home. You need to keep your home clean. |
No impact. |
No impact. |
| Your support |
You may need help to do dialysis at home. Your caregiver will need training on how to do it. Nurses can be contacted 24 hours a day for support. |
You may need someone to help you travel to and from the dialysis centre. |
Your medical team can support you and your family when needed. Home care services are available if needed. |
Quality of life, risks, and cost
Here is a summary of what is known about the benefits, risks and costs of each treatment option:
| Your Kidneys, Your Plan |
Dialysis |
Kidney Supportive Care
(KSC / Conservative Management) |
Peritoneal Dialysis
(PD / Water Dialysis) |
Hemodialysis
(HD / Blood Dialysis) |
| Quality of Life |
Dialysis may help manage your symptoms. However, the side effects of treatment
may lower your quality of life. Dialysis also does not help with other serious health
problems (such as diabetes or heart problems).
Getting dialysis also reduces time for other activities.
|
KSC may help manage your symptoms. Usually quality of life remains stable
until the last 1-2 months of life, when it begins to drop steadily.
You can go on with your daily activities.
|
|
A study with elderly (aged 75 and above) people with Kidney Failure in Singapore
showed the following2:
|
| Side Effects |
If PD is done well, you will have few side effects.
If your catheter site is not kept clean, it may lead to infection.
Your sleep may be disturbed if you do APD.
|
After a dialysis session, you may:
- Feel tired.
- Have low blood pressure.
- Feel dizzy.
- Need a few hours to fully recover.
|
You will likely have the symptoms of Kidney Failure. Medicine and lifestyle
changes can help reduce these symptoms. However, the medicine may have some
side effects.
|
| Treatment risks |
You may face:
- Bleeding at surgery site.
- Intestinal injury.
- Painful infection around catheter.
- Other problems with catheter (e.g. blockage).
These problems may be solved with medicine or minor surgery.
|
You may face:
- Vein blockage
- Blood infection
- Painful infection and clotting around catheter.
- Other problems with graft or catheter (e.g. blockage).
These problems may be solved with medicine or minor surgery.
|
There are no treatment-related risks. |
| Total expected cost (SGD) of dialysis without medication and consultation (before subsidy) |
You can use Medishield Life and Medisave to pay for dialysis.
You can check with your medical social worker if you qualify for aid from the Voluntary Welfare Organisations (e.g. National Kidney Foundation, Kidney Dialysis Foundation).
|
There will be costs for medicines and consultations. There are no costs related to dialysis. |
|
CAPD: $1,500-$1,800 per month.
APD: $1,700-$2,100 per month excluding electricity bill.
|
$2,800-$3,500 per month excluding transport cost. |
If you are interested to know your personalized risk under different treatment options, please click
here.