Kidney failure triggered by diabetes heightens demand for transplants

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April 21, 2015—The number of Canadians with end-stage kidney disease (ESKD) increased by 35% in the last 10 years. During a similar period, the number of Canadians with diabetes—the number 1 cause of ESKD—increased by 60%. This means that by the end of 2013, almost 42,000 Canadians were living with ESKD, creating an unprecedented demand for regular dialysis treatments and kidney transplants.

New numbers published in the Canadian Organ Replacement Register (CORR) annual report by the Canadian Institute for Health Information (CIHI) show that nearly 36% of new ESKD cases were due to diabetes. These conditions have particularly affected older Canadians. Between 2003 and 2013, the number of Canadians age 45 to 64 with ESKD increased by 46%, while Canadians 65 and older saw a 66% increase. During the same time period, the number of Canadians age 45 and older with diabetes also increased by more than 60%.

While approximately 58% of patients with ESKD required some form of dialysis treatment in 2013, patient outcomes and quality of life are much better for patients who are able to receive a kidney transplant.

“For most patients, the best treatment option for ESKD is a kidney transplant. Not only do these patients live longer, their quality of life is typically much better than that of patients who depend on dialysis treatment. Unfortunately, the demand for donated kidneys continues to exceed the supply.”

– Greg Webster, CIHI’s director of Acute and Ambulatory Care Information Services

Dialysis can have a big impact on patient quality of life. More than three-quarters of dialysis patients are on institutional hemodialysis, which requires travel to clinics multiple times a week for treatment. Dialysis is also more costly to the health care system than a transplant, with a price tag of up to $250,000 more per patient over a 5-year period.

Prevention and management

For patients with ESKD, the chance for positive outcomes increases when they are diagnosed and managed earlier to help slow the condition’s progression.

“The conversation about the declining health of Canadians has been going on for a long time. Conditions like obesity and type 2 diabetes are on the rise and can lead to other health problems such as chronic kidney disease. An overall improvement in the health of the population would likely lead to fewer Canadians requiring treatments for organ failure, such as dialysis and transplantation. However, efforts to make these treatments readily available to the people who need them must continue, including increasing organ donation rates.”

– Dr. Joseph Kim, medical director of the Kidney Transplant Program, Toronto General Hospital, University Health Network, and president of the CORR Board of Directors

Organ donations in Canada

The 2013 data reveals a steady increase in the number of organ donors in Canada; it also shows that the number of living donors has surpassed the number of deceased donors. In 2013, there were 588 living donors and 553 deceased donors (an increase of 49 and 12 donors from 2012, respectively).

Though the number of living and deceased donors in Canada is improving, a gap remains between the number of patients waiting for an organ and the number of organs available from donors. At the end of 2013, there were 4,433 patients waiting for a solid organ transplant.

A recent CIHI report, Deceased Organ Donor Potential in Canada, found that approximately two-thirds of deceased patients younger than 70 and eligible to donate do not make it through the complex organ donation process. According to the study, there is a strong potential to increase the number of donations from older donors and donations after cardiocirculatory death across the country. An estimated 3,577 organs could have been available for transplant if donors had been better identified and managed through the appropriate steps of organ donation.

Organ transplants by the numbers

2,432 solid organs were transplanted in Canada in 2013:

  • Kidneys: 1,419
  • Livers: 509
  • Lungs: 247
  • Hearts: 192
  • Pancreases: 65

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