Number of Canadians living with kidney failure triples over 20 years

Renal transplantation saving millions in dialysis costs

What : Treatment of End-Stage Organ Failure in Canada, 2000 to 2009

January 20, 2011—The number of Canadians living with kidney failure, otherwise known as end-stage renal disease (ESRD), has been steadily increasing for 20 years, but rates now appear to be stabilizing, according to a new report from the Canadian Institute for Health Information (CIHI).

The Canadian Organ Replacement Registry annual report, Treatment of End-Stage Organ Failure in Canada, 2000 to 2009, reveals that close to 38,000 Canadians were living with kidney failure in 2009—more than triple the number (11,000) living with the disease in 1990. The largest increase occurred in older age groups, with prevalence rates escalating by more than 500% for those age 75 and older. Patients in this age group account for 20% of all kidney failure cases.

Of all Canadians living with the disease in 2009, 59% (22,300) were on dialysis and about 3,000 people were on the wait list for a transplant, compared with 53% (5,900) on dialysis in 1990 and roughly 1,600 people on the wait list.

Louise Moist, Nephrologist and Associate Professor of Medicine at the University of Western Ontario, explains: “While the number of kidney failure patients has been increasing in Canada, the supply of kidneys available for transplant has not kept pace with the growing demand. Dialysis treatments come at great cost not only to the health care system but also to the patients’ quality of life. On average, dialysis patients require treatment in a dialysis centre three times per week, often for four hours per session.”

CIHI’s report also shows that the rate of people living with kidney failure steadily increased between 1990 and 2000 but appears to have levelled off since 2005. This may be due, in part, to patients seeing a nephrologist in earlier stages of the disease, possibly contributing to a delay in the onset of kidney failure.

“Diabetes continues to be a leading cause of kidney failure,” says Moist. “With rising obesity rates and an aging population, there needs to be a focus on educating Canadians on how to prevent the onset of these diseases that add a heavy burden to our health care system.”

Kidney failure results in substantial costs to the health care system. For example, CIHI’s estimated cost for hemodialysis treatment is approximately $60,000 per patient, per year of treatment. A one-time cost for a kidney transplant is approximately $23,000 plus $6,000 for necessary annual medication to maintain the transplant. Based on CIHI’s estimates, over a five-year period, the cost savings of receiving a transplant rather than dialysis treatment is approximately $250,000 per patient.

In 2009, the more than 15,000 patients living with kidney transplants saved the health care system an estimated $800 million. There are currently about 3,000 people on the wait list for a kidney transplant. If they all receive a transplant, it could result in additional savings of $150 million annually.

Other key highlights of the report include the following:

• In 2009, there were 5,400 newly diagnosed patients with kidney failure—more than double the number of people newly diagnosed in 1990 (2,300). Of the 5,400, more than three-quarters (78%) were treating the disease using hemodialysis.
• The average age of new adult patients starting hemodialysis—the most common form of dialysis—was 65 in 2009, up from 55 in 1990.
• People are seeing nephrologists sooner, which is a very positive trend. In 2009, only 31% of patients were “late referrals” (patients that need to start dialysis less than three months after first seeing a nephrologist)— down from 42% in 2001.
• Diabetes continues to be the predominant cause of kidney failure in Canada: one in three people with kidney failure has diabetes.
• Of all Canadians with kidney failure in 2009, 39% were living with functioning kidney transplants, compared with 47% in 1990.
• CIHI cost estimates indicate that
• An annual cost for hemodialysis treatment (the most common form of dialysis) is approximately $60,000 per patient, based on an average of three visits weekly (excluding physician fees or procedures that take place outside of hospital settings).
• The average cost of a one-time kidney transplant is $23,000 (including hospital stay, excluding physician fees, drugs administered outside of a hospital setting and follow-up costs) plus $6,000 for necessary annual medication to maintain the transplant.
• In 2009, the more than 15,000 patients living with kidney transplants saved the health care system an estimated $800 million. There are currently about 3,000 people on the wait list for a kidney transplant. If they all receive a transplant, it could result in additional savingsof $150 million annually.

Media contacts

Angela Baker
416-549-5402
Cell: 416-459-6855
anbaker@cihi.ca

Jennie Hoekstra
519-453-5990
Cell: 519-317-1105
jhoekstra@cihi.ca

The report and the following figure and table are available from CIHI’s website, at www.cihi.ca.

• Figure 1: Prevalence Rate for Patients on Dialysis or With Functioning Transplant in Canada, 1990 to 2009 (Rate per Million Population) (Figure 2 in the report)
• Table 1: Prevalent End-Stage Renal Disease Patients by Age Group, Canada, 1990 to 2009 (Number, Rate per Million Population) (Table 11 in the report)