NKF: Beyond Dialysis

Much has been debated about the National Kidney Foundation but I feel that there is something else that needs to be said. It is not about the way the it raises, spends or keeps it money, but about health.

Throughout the recent debate, there seemed to be broad consensus that the NKF is doing a great job in caring for kidney patients and helping to save lives. I believe more can be done.

Many years ago, a friend of mine received an appeal letter from the NKF and he wrote back to say that he would donate provided the organisation spent some money on research on how to prevent kidney failure. He got no reply. And so to this day, he has not sent in his donation.

The focus of the NKF's work, and the bulk of its hefty expenditure, has been on providing dialysis treatment for kidney patients. This is akin to fire fighting, or crisis management. It's an urgent task that needs to be done.

Over the years, however, the NKF has developed into a strong and stable organisation with an efficient management and, as the public discovered recently, huge capital reserves.

This is a good time for it to step back and look into broadening its role to cover prevention instead of just treatment. It is not that there are no longer kidney patients urgently in need of dialysis. There will always be.

Root cause

But at some point, we will need to tackle this problem at its root because otherwise it will just get bigger and bigger. Already, Singapore has one of the highest rates of kidney failure in the world. Do we want to become Number One?

It is true that the NKF has been providing free health screenings, reaching out to Singaporeans in their HDB estates and shopping malls.

Screening, however, is NOT prevention. It is detection. It is merely finding out, hopefully at an early stage, that a health problem exists, so that appropriate treatment can be given. Ultimately, it still leads back to treatment.

Likewise, when the Breast Cancer Foundation encourages women to go for mammogram to "prevent" breast cancer, or when doctors advise people to go for annual medical check-ups, it is not prevention, but simply detection. The NKF cannot be faulted for thinking like the others.

High protein diet

Prevention is about not having the problem arise in the first place. In the case of kidney disease, it is widely known – at least by healthcare professionals and those who take an active interest in health, if not by the general public – that a high-meat / high-protein diet is a major cause.

Eating less meat and protein is thus one way to prevent kidney disease. Does the NKF actively inform the public about this? Does it actively encourage people to eat less meat and protein? Has it responded in any way to the current "low-carb" diet craze that avoids carbohydrates and emphasises eating protein as the main food?

I have not been following the activities of the NKF closely, but even if it has been putting out such messages, I have not come across them.

What I did come across once, about three years ago, actually puzzled me about the intentions of the NKF.

It was a poster proclaiming that "Sugar does not cause of diabetes". From far, I thought it was an advertisement by the Sugar Industries of Singapore, until I took a closer look and was shocked to see that it was actually a "health education" poster from the NKF.

I cannot remember its details but I remember feeling it was similar to saying that "speeding does not cause road accidents" but that the actual cause is carelessness or inability to control the car. In other words, the message was technically correct, but totally uncalled for.

Salt

Instead of endorsing sugar, the NKF would have been better off warning against excessive salt intake, since this, too, is a known cause of kidney damage.

Lesser known, however, is that in Traditional Chinese Medicine and macrobiotics, mildly salty foods – such as seaweeds and food prepared with small amounts of good quality, natural, sea salt – are considered strengthening for the kidneys.

In fact, oriental medicine has plenty to say about how to care for the kidneys, since the kidneys, along with the adrenal glands and reproductive organs, are regarded as a major organ system responsible for a person's overall vitality.

And so there are plenty of herbs, tonic foods, exercises, massage, etc for keeping the kidneys in good shape.

These may not be scientific. But that is mainly because the organisations that normally fund scientific research, namely the pharmaceutical and medical industries, have little interest in studying such things because they have little commercial value.

One cannot create a multi-billion dollar business out of, say, selling aduki beans (small red beans), one of the many foods said to nourish the kidneys. And certainly not from encouraging people to walk on grass that is wet with dew early in the morning, another kidney strengthener.

Ginger compress

Here is another method that I had learnt:

1. Bring a big pot of water nearly to the boil, until bubbles form at the sides. Crush a handful of ginger and throw into the hot water.
2. Dip a large towel into the hot water, squeeze it nearly dry, fold and place over the kidneys. Take care that the heat is tolerable, so that you do not scald the skin. Cover with another dry towel to keep the heat.
3. When the towel cools down, change to a new one. Repeat the process for about 20 minutes, until the skin around the area is red.

This treatment draws blood to the kidneys to heal it. It's a simple yet powerful treatment. I know of people who were on the verge of kidney failure but managed to avoid dialysis just by doing this.

The medical and drug establishments do not have much interest in finding out how effective such treatments are. But an organisation like the NKF could save millions of dollars annually – and a lot of lives – if such treatments are confirmed to be truly effective.

Being in Singapore, with its rich mix of Western medical science and traditional remedies from China, India and Southeast Asia, presents an organisation like the NKF with a golden opportunity to do pioneering work in in establishing affordable and effective healthcare.

Over the years, the NKF has established itself as an organisation with power, influence, money and a relatively high standing in society. It can achieve much more good by thinking out of the box, beyond dialysis.