Clinical Nephrology and Chronic Kidney Disease

Comprehensive, Personalised Kidney Care for Every Stage of Your Journey

Our Clinical Nephrology and Chronic Kidney Disease (CKD) provides care for patients with all types of kidney diseases, including high blood pressure (hypertension), electrolyte imbalances, kidney stones, and cystic kidney diseases. Special attention is given to managing diabetic kidney disease, with the goal of slowing progression to end-stage kidney failure.

To support accurate diagnosis and personalised care, we offer advanced services such as 24-hour ambulatory blood pressure monitoring (ABP), and body composition monitoring (BCM) to assess body fluid status and nutrition. These services help us tailor treatment plans to each patient’s needs and improve health outcomes.

Low Clearance Clinic (LCC)

The Low Clearance Clinic supports patients with advanced CKD by focusing on optimising kidney health, slowing disease progression, and preparing patients for long-term renal care, such as dialysis or transplantation. The clinic takes a patient-centred, multidisciplinary approach to manage the complex medical issues associated with advanced CKD. The care team includes renal physicians, advanced practice nurses, coordinators, dietitians, pharmacists, social workers, transplant coordinators, befriender services from the National Kidney Foundation (NKF), and Advanced Care Planning (ACP) coordinators. The primary emphasis at LCC is on active medical management and preparation for possible end-stage renal disease.

Renal Medication Titration Service (RMTS)

The Renal Medication Titration Service is a clinical service delivered by Advanced Practice Nurses and Pharmacists to optimise renal-related medications to slow the progression of chronic kidney disease (CKD). Available as virtual consultations to enhance patient’s convenience, this service ensures medications are titrated according to clinical guidelines. The healthcare providers work closely with each patient to optimise their renal-related medications with consideration of one’s disease progression and any medication-related complications.

Obstetric Kidney Clinic (OKC)

Our Obstetric Kidney Clinic (OKC) is a dedicated multi-disciplinary specialized care for women with kidney conditions whom are planning for pregnancy or are already pregnant. Established in 2020 this is a unique clinic, where we integrate expertise from Nephrology, high-risk obstetrics, pharmacy and nursing to optimize outcomes for both mother and baby. We recognize that pregnancy in women with kidney conditions presents unique challenges. Our unique clinic is designed to deliver personalized, evidence-based, and compassionate care in a single, well-coordinated setting.

Our specialized team includes nephrologists, maternal-fetal medicine specialists (high-risk obstetricians), obstetric nurse coordinators, renal coordinators, clinical pharmacists, medical social workers and dietitians.

Conditions we manage include CKD in pregnancy, proteinuria or glomerular diseases (e.g. IgA nephropathy, Lupus nephritis) during  pregnancy, hypertensive kidney disease in pregnancy, preeclampsia with underlying or emerging renal dysfunction, patients with end-stage-kidney-disease (ESKD)-dependent on dialysis undergoing pregnancy.

We provide specialized care for:

• Preconception counselling & Risk assessment for women with kidney conditions: For women with CKD or history of kidney disease planning pregnancy, including transplant recipients and patients with autoimmune kidney disease.
• Antenatal Management and Surveillance for pregnant women with kidney conditions: Close follow-up of maternal renal function, blood pressure, and fetal well-being throughout pregnancy.
• Management of kidney-related complications during pregnancy: If kidney condition requires initiation of dialysis this will be managed closely throughout pregnancy.
• Medication adjustment and monitoring during pregnancy: Safe adjustment of immunosuppressants, antihypertensives, and other nephrology/obstetric medications during pregnancy and postpartum.
• Postpartum Follow-up and Recovery: Necessary follow-up with Nephrology and Obstetric clinics will be arranged for postpartum care for ongoing care for renal health, lactation-safe medications, etc.

Polycystic Kidney Clinic

The Polycystic Kidney Clinic supports patients with genetic polycystic kidney disease (PKD) by focusing on three key areas: diagnosing disease and assessing risk of disease progression (using radiological imaging, blood test trends, and/or genetic test), slowing disease progression (using pharmacological and non-pharmacological measures), and monitoring of disease-related complications and symptoms. The clinic takes a patient-centred, multidisciplinary approach to manage the medical issues associated with PKD. Our care team includes renal physicians, renal coordinators, and renal pharmacists. The care team will also coordinate with other specialists to manage complex PKD-related conditions.

SAF-Medical Classification Centre (MCC)

The Singapore Armed Forces (SAF) – Medical Classification Centre (MCC) Clinic is a specialised service dedicated to supporting pre-enlistees with potential kidney issues identified during routine medical screening. These include asymptomatic microscopic haematuria, proteinuria, reduced kidney function (GFR), and congenital kidney or urinary tract abnormalities (CAKUT). Our clinic provides timely and thorough evaluation to detect under-recognised hereditary kidney conditions, undiagnosed glomerulonephritis, and other forms of chronic kidney disease (CKD). By enabling early diagnosis, intervention, and structured follow-up, we aim to prevent disease progression to end-stage kidney disease (ESKD) and improve long-term health outcomes for Singapore’s young adult population

Ambulatory Blood Pressure Monitoring (ABPM) Service

The Ambulatory Blood Pressure Monitoring (ABPM) service is part of our specialised hypertension and renal care services. ABPM offers a comprehensive, 24-hour profile of a patient’s blood pressure by taking automatic readings at regular intervals during daily activities and sleep. This is particularly valuable for identifying conditions such as white coat hypertension, masked hypertension, and for evaluating the effectiveness of current blood pressure treatments. It offers a more accurate and comprehensive assessment than single readings taken in a clinic setting.

Patients are fitted with a compact, wearable device that records blood pressure throughout the day and night. The collected data is then analysed by our clinical team to support precise diagnosis and tailored treatment planning. ABPM plays a key role in enhancing the quality of care for patients with, or at risk of, kidney disease and cardiovascular complications.

Renal Supportive Care Clinic (RSC)

The Renal Supportive Care Clinic is dedicated to providing holistic, compassionate support for patients and families living with advanced kidney disease, especially when symptom relief and quality of life become the main focus. RSC offers specialised palliative care, helping patients manage symptoms such as pain, breathlessness, and fatigue, and provides emotional, psychological, and spiritual support. The clinic guides patients and their families through care planning and shared decision-making, respecting individual values and cultural beliefs. The multidisciplinary team works alongside renal physicians and is deeply involved in supporting patients and their families at any stage of the illness.

Renal Bone Clinic

The Renal Bone Clinic provides specialised care for bone diseases related to chronic kidney disease (CKD). Our multidisciplinary team, which includes nephrologists, surgeons, interventional radiologists, dermatologists, endocrinologists, nurses, and pharmacists, manages a wide range of conditions. These include bone disease due to high parathyroid hormone levels, osteoporosis in both CKD patients and the general population, post-transplant bone disease, and calcificuremic arteriopathy (calciphylaxis). The team places particular emphasis on treating hyperparathyroid bone disease, addressing vascular calcification, and maintaining bone health after kidney transplantation. Each patient receives an individualised, evidence-based treatment plan aimed at improving outcomes and enhancing quality of life.

Fluid Blood Pressure Clinic

The Fluid BP Clinic is designed to help patients with CKD who are experiencing high BP and/or excess fluid in their bodies. This multi-disciplinary clinic uses objective volume assessment methods, including body impedance analysis, to guide personalised education and action plan coaching to patients. We empower patients to manage their fluid volume and hypertension effectively and improve their overall well-being.