Ontario Renal Network | Reseau Renal de L'Ontario

Impact of Chronic Kidney Disease

Ontario Renal Reporting System
Improving care and quality of life for CKD patients begins with understanding the disease’s impact. Since 2010, the Ontario Renal Network, in cooperation with Regional Renal Programs in Ontario, has been collecting comprehensive data across the province. The resulting database, known as the Ontario Renal Reporting System, guides our capacity planning, funding, system improvements and performance management. boxes

Impact of CKD in Ontario

Personal impact

Chronic kidney disease patients and their families may have to deal with significant physical discomfort, emotional stress, financial difficulties and major lifestyle changes.

CKD requires lifelong, intensive treatment. In the early stages, patients begin working with a team of physicians, nurses, dietitians, social workers and pharmacists to slow the progression of kidney failure through lifestyle changes and medication. Early detection is ideal, but CKD often goes undetected in its early stages. In 2014, about a quarter of new dialysis patients were “crash starts,” which means they went straight to dialysis without prior care (source: Ontario Renal Reporting System, 2014).

When the kidneys fail, options include renal replacement therapies such as dialysis or transplant, and/or palliative care. Patients can receive hemodialysis in a hospital, a community-based facility or at home. Peritoneal dialysis is normally performed at home.

Patients who can manage dialysis in their homes frequently report better quality of life and greater independence. As of June 2014, almost one quarter of dialysis patients in Ontario managed their care at home with the remainder receiving hemodialysis in a hospital or community facility.

almost 25% of patients use home dialysis

Many patients can benefit from dialysis support outside hospital clinics. For example, all Ontario Community Care Access Centres now offer some form of dialysis support, as do a small percentage of long-term care facilities.

Kidney transplantation provides the best long-term outcome for patients with end-stage kidney disease. Kidney transplantation rates in Ontario, though, are relatively low.

In Ontario, Trillium Gift of Life Network maintains the transplant wait list.

  • Number of people deemed suitable for transplant as of 2013: 1,088
  • Median time to receive a kidney from a deceased donor: 4.2 years
  • Median time to receive a kidney from a living donor: 0.9 years
  • Total kidney transplants in 2013: 546
  • Total kidney transplants in 2004: 404

Living donations, which result in better outcomes, have not kept pace with deceased donations. Over the most recent 5-year period, the number of living donor transplants has fallen in Ontario.

Impact on Ontario’s healthcare system

About 12,000 people in Ontario have CKD requiring pre-dialysis care. An additional 10,500 Ontarians have advanced CKD, and require dialysis.

Dialysis has been on the rise for more than a decade. Changing demographics and increasing prevalence of risk factors means there is no abatement in sight:

  • Aging: CKD is more common in later in life. People aged 65 years and older now represent almost 15% of Ontario’s population, rising to one quarter by 2036.
  • Diabetes: In 2014, almost 10% of Ontarians had diabetes, putting them at higher risk for CKD. By 2024 diabetes rates will rise to 13%.
  • Hypertension: Ontario’s rate of hypertension is higher than the national average and rising. Hypertension is another important risk factor for CKD.
  • Aboriginal populations also have a rate of end-stage kidney disease that is triple that of non-Aboriginal communities.