SINGAPORE: A new programme developed by local healthcare services may help reduce kidney deterioration in diabetic patients, the National University Hospital (NUH) and the National Healthcare Group Polyclinics (NHGP) announced on Monday (Aug 1).
The programme, called the Nephrology Evaluation, Management and Optimisation (NEMO) Programme, is an enhanced collaborative disease management initiative by NUH and NHGP.
Under the programme, NEMO coordinators at participating polyclinics help identify diabetic patients with early signs of kidney disease. The coordinators then work with the patients and their doctors to educate the patients on their condition, explain treatment methods and provide advice on self-care management, such as diet and medication.
There is currently one coordinator stationed at each of the nine NHGPs.
At the same time, doctors will also work with the coordinators to manage the patient’s kidney disease by optimising their drug prescriptions. This include drugs such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB), which are drugs that can help lower blood pressure and as a result, reduce protein in urine.
The absence of protein in urine, or a reduction in protein levels in urine, is an indication of improved kidney functions.
According to studies by NUH and NHGP, about 51 per cent of patients who were enrolled in NEMO were found to have either no more protein leakage in the urine or have had a significant decrease in their protein leakage into the urine. Of the 3,304 patients who were analysed, 28 per cent also had a lower rate of worsening kidney function compared to those who had not participated in NEMO.
Professor A Vathsala, Director of the NEMO Programme and Senior Consultant at the Division of Nephrology at NUH said: “We are confident that this programme will help to stem the rising incidence of end-stage kidney disease due to diabetic kidney disease among patients with diabetes on follow-up at the primary care setting in the coming years.
“The benefits of preventing kidney disease progression are more far-reaching than kidney disease alone,” she added.
Diabetic kidney disease is currently the leading complication for those whose diabetes is poorly controlled. It is also the main cause of end-stage kidney disease in Singapore.