The sharp rise in the cost of treating end-stage kidney disease (ESKD) is alarming as the figures have increased six-fold over the past decade to RM3.3 billion annually. This trend is unsustainable and reflects a wider “silent epidemic” driven largely by non-communicable diseases, particularly Diabetes Mellitus and Hypertension. 

The most effective and sustainable solution is prevention. Greater emphasis must be placed on early intervention, including nationwide screening for high-risk groups and tighter control of diabetes and blood pressure. The expanded use of SGLT2 inhibitors is a positive step, as these therapies not only manage diabetes but also significantly reduce the risk of kidney disease progression.

Early detection must also be strengthened. Routine kidney function testing should be integrated into primary care, particularly for those with underlying conditions. Detecting chronic kidney disease (CKD) earlier can delay or even prevent progression to ESKD, reducing long-term healthcare costs.

The Ministry of Health’s “PD-first” approach and calls for further expansion of Peritoneal Dialysis needs support. This method is more cost-effective, reduces congestion in dialysis centres, and allows patients greater independence. However, stronger patient education, home support systems, and incentives are needed to increase uptake.

Meanwhile, Malaysia must accelerate efforts to expand access to Kidney Transplant, which remains the most cost-effective long-term treatment. This requires boosting organ donation rates, strengthening transplant infrastructure, tax relief for donors, and enhancing public awareness.

Financial protection for patients must not be overlooked. Targeted subsidies, transport assistance, and low-interest financing schemes should be introduced to ease the burden on affected families, particularly in the current climate of rising living costs exacerbated with the ongoing fuel crisis.

Finally, sustainable healthcare practices must be prioritised. Dialysis, especially Haemodialysis, consumes vast resources and generates significant waste. Investments in greener technologies and more efficient systems are urgently needed.

Kidney failure is not merely a medical issue but a national challenge. A comprehensive, prevention-first strategy is essential to safeguard both public health and the long-term sustainability of Malaysia’s healthcare system.

Dato’ Dr Mah Hang Soon
MCA Deputy President

13 April 2026

-MCA Comm-