Kidney failures up 57% over 10 years

More Canadians are living with end-stage kidney disease and waiting for transplants today than a decade ago, according to a new report.

The Canadian Institute for Health Information released its report on treatment of end-stage organ failure in Canada on Tuesday, based on data from 1999 through 2009, the most current year available.

An estimated 36,638 people were living with end-stage renal disease in Canada at the end of 2008, an increase of 57 per cent since 1999, according to the report. Of these, 21,754 were on dialysis, which takes over the job of purifying a person's blood once the kidneys can no longer perform that function effectively.

Of the 4,167 Canadians waiting for an organ transplant as of Dec. 31, 2009, 2,941, or almost 71 per cent, were waiting for a kidney, the Kidney Foundation of Canada said.

At the start of 2009, 5,431 kidney patients had started either dialysis or a kidney transplant in 2009, up one per cent from the previous year.

Diabetes continued to be the main cause of end-stage renal disease in Canada, identified as the cause in 35 per cent of new cases.

Better survival with transplants

"I think it's important to be aware of the fact diabetes causes renal disease and is a major cause of people requiring replacement therapy for their kidneys, be it dialysis or transplantation," said Dr. Ian Alwayn, surgical lead of the Multi-Organ Transplant Program at Halifax's QE II Health Sciences Centre.

"As we know, the population, in Canada and worldwide, is becoming more and more obese, and obesity is also associated with an increased risk of diabetes and, as such, renal failure."

Mike Blondeau, 37, of Saskatoon has diabetes and says his life depends on the 12 hours of dialysis per week he must undergo. He has been living with kidney failure for the last 18 months and says a kidney transplant is his best hope for a normal life.

"I've talked to a lot of patients that have had [transplants]," Blondeau said. "Their lives are back to normal. That's my goal."

On average, about 50 to 60 per cent of patients without diabetes who are receiving end-stage renal replacement therapy, such as dialysis, survive, said Alwayn. If these patients receive a transplant, survival improves to about 80 to 90 per cent at five years after the transplant, he added.

Waiting for organs

The study also found that the age at which Canadians get kidney disease has risen in the past decade. In 2008, 53 per cent of those who started treatment for renal disease were 65 or older compared with 49 per cent in 1999.

The report also looked at liver, heart, lung and pancreas transplants.

In 2008, 453 liver transplants were performed in Canada, and 587 patients were waiting for a transplant, a number that has declined from its peak of 723 in 2006, the report's authors said.

In 2008, 164 heart transplants were performed in Canada. The number of heart transplants per year fluctuated between 147 and 178 over the previous decade. Overall, 1,588 Canadians received a first heart transplant during the 10-year study period.

In 2008, 165 lung transplants were performed, down from the 187 performed in 2007. People with cystic fibrosis accounted for 81 per cent of double lung transplants, and those diagnosed with emphysema had the most single-lung transplants.

There were 282 Canadians waiting to receive a lung transplant in 2008, up from 168 in 1999.

Between 1999 and 2008, there were 671 pancreatic transplants performed in Canada. Almost three-quarters (72 per cent) of those were simultaneous pancreas–kidney transplants.