Wave, March / April 2013
Some First Nations residents will soon be able to get renal screening in their own communities under a new program that aims to reduce high rates of kidney failure among Aboriginal people in Manitoba.
The First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis project, also known as FINISHED, was unveiled last month.
The $1.6 million project was developed by the Winnipeg Health Region's Manitoba Renal Program in partnership with the Diabetes Integration Project (DIP). It is funded through Health Canada's Health Services Integration Fund.
Manitoba has some of the highest rates of kidney disease in the country. The disease is often caused by diabetes, with Aboriginal people three times more likely to seek dialysis treatment after kidney failure to stay alive.
Dr. Mauro Verrelli, Medical Director of the Manitoba Renal Program, says the in-community screening program can help reduce rates of kidney failure as well as the number of people who require dialysis. As he explains, if the disease is diagnosed in the early stages, medication and lifestyle changes can be used to help avoid further damage to the kidneys. "We want to prevent people from needing dialysis," says Verrelli.
"The earlier we can diagnose kidney disease, the better the outcome is for the individual."
When discovered in later stages or when it has become end-stage renal disease (ESRD), options for treatment become limited and renal replacement therapies such as dialysis or transplant are needed. Only about 50 per cent of Manitobans with advanced kidney disease who start dialysis live longer than five years.
Under the project, health-care workers will visit First Nations communities in the West Region and Island Lake areas. The screening teams will start in Rolling River First Nation in March and visit several other communities until March of 2015.
"We hope to demonstrate that this type of screening is sustainable and beneficial for both the individuals and the healthcare system," says Dr. Paul Komenda, a nephrologist with the Manitoba Renal Program and co-leader of the FINISHED project. "Earlier diagnosis can increase treatment options and quality of life, while reduced use of dialysis can be a huge cost-saving to the health region."
The FINISHED project will use DIP's existing model of care to deliver screening clinics in the communities. DIP currently provides mobile diabetes screening in First Nations communities through the First Nations Inuit Health Branch's Aboriginal Diabetes Initiative.
"We engage the community and work with them when planning and implementing the screening clinics," says Caroline Chartrand, Executive Director of the Diabetes Integration Project. "FINISHED is about creating partnerships to provide better access to care and treatment, and carrying through with that integrated approach in all aspects of the project."
For more information about FINISHED, visit www.kidneyhealth.ca or call the Diabetes Integration Project at 204-956-7174 or 1-855-333-9320. You can also contact First Nations community health centres or nursing stations.
Amie Lesyk is a communications advisor with the Winnipeg Health Region.
Why is this project needed?
Many people don't know they have kidney disease until they are very sick and need dialysis to stay alive. The impact of kidney failure on quality of life is huge because patients are often uprooted from their communities, forced to quit work or school, face multiple hospitalizations and lose independence as a result of dialysis. The societal cost can also be enormous. One dialysis patient may directly cost the health-care system approximately $550,000 over their lifetime, not including the productivity loss of early death and discontinuation of employment.
Who are the project partners?
The Diabetes Integration Project (DIP) is an integrated diabetes health-care service delivery model that was developed to begin to address the needs for First Nations people who have been diagnosed with diabetes. The project will overcome barriers to access to a comprehensive, co-ordinated and integrated diabetes care and treatment service for limb, eye, cardiovascular and kidney complications. The DIP will utilize mobile diabetes health-care service delivery teams to provide diabetes care and treatment services in First Nation communities throughout Manitoba.
The Manitoba Renal Program (MRP) is a clinical program of the Winnipeg Health Region that provides education and care for people at risk of developing kidney disease and people with chronic kidney disease. Primary services offered by the Manitoba Renal Program include kidney health care, hemodialysis care, peritoneal dialysis care, and renal health outreach. Hemodialysis is offered in Winnipeg, Brandon, and 16 rural locations throughout the province.
DIP and MRP are working alongside federal, provincial and community stakeholders to ensure an integrated approach to developing and implementing the FINISHED project. Consultation with all communities is ongoing to ensure a tailored approach to screening delivery and community engagement.