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Province's rate of advanced kidney disease near highest

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Manitoba has the second-highest rate of advanced kidney disease in the country, and it also has some of the longest waits for kidney transplants.

The news was contained in a report released Thursday by the Canadian Institute for Health Information (CIHI).

Only Newfoundland and Labrador has a higher incidence of end-stage renal disease (ESRD) than Manitoba, the report says. Meanwhile, only in British Columbia is the median wait for a deceased-donor kidney transplant longer than it is in Manitoba -- 5.4 years as opposed to 5.1 years. The national average median wait time was 3.8 years for the study period (2009 to 2011).

In a companion report, the CIHI also said aboriginal people are three times as likely to seek treatment for kidney failure or end-stage renal disease as other Canadians. And aboriginal patients with ESRD are less likely to receive kidney transplants (27 per cent versus 42 per cent).

However, aboriginal people who do receive a new kidney have survival rates similar to others in Canada (84 per cent at five years). In contrast, aboriginal patients who undergo dialysis have a lower survival rate after five years (40 per cent versus 45 per cent).

In all, more than 40,000 Canadians are living with end-stage renal failure -- roughly one out of every 1,000 people.

The condition's higher prevalence among aboriginal peoples is consistent with the higher rates of diabetes and obesity in these populations, CIHI said.

End-stage renal disease is often caused by diabetes -- rampant in many First Nations communities -- and high blood pressure. Patients usually develop it after years of chronic kidney disease.

Health Minister Theresa Oswald said Thursday the overall message from the two reports is "clear and jarring," and governments still have a lot of work to do to diminish the gap in health status between aboriginal and non-aboriginal people.

In recent years, the province has boosted the number of rural and northern dialysis units to 16 from nine, she said. It even has brought such services to First Nations themselves, including Norway House, even though the delivery of health services on reserves is Ottawa's responsibility.

"We really need an authentic and committed partner in the federal government to be able to really stem the tide of some of the renal disease that we're seeing in Manitoba," Oswald said, noting it's impossible to operate a dialysis station in locations that don't have access to clean water.


ESRD by the national numbers

There were an estimated 40,385 Canadians living with end-stage renal disease (ESRD) in Canada at the end of 2011, more than triple the number recorded in 1992.

Of these, 23,423 were on dialysis and 16,962 were living with a functioning kidney transplant.

At the end of 2011, there were 3,406 patients waiting for a kidney transplant in Canada, an increase of 23 per cent since 2005.

Of the 1,247 kidney recipients during 2011, 194 received so-called pre-emptive transplants (where the transplant is performed immediately upon diagnosis of end-stage renal failure, with no time on dialysis).

Diabetes continues to be the predominant cause of ESRD in Canada, identified in 35 per cent of new cases in 2011.

-- Canadian Institute for Health Information

Republished from the Winnipeg Free Press print edition February 15, 2013 A14

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