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Number of patients on dialysis increases 30%

The number of Canadians outside Quebec on dialysis increased 30% between 2006 and 2015.

Roger Collier | CMAJ | Feb. 2, 2017

There were 36 251 Canadians outside Quebec living with end-state kidney disease in 2015, an increase of 36% since 2006, and 21 214 of these patients were on dialysis, up from 16 388, according to the report High Risk and High Cost: Focus on Opportunities to Reduce Hospitalizations of Dialysis Patients in Canada by the Canadian Institute for Health Information (CIHI). Many patients receiving dialysis required hospitalization, often for preventable infections, at a cost of approximately $310 million a year.

Children receiving dialysis had the highest risk of hospitalization, 173% higher than any other age group. On average, the annual cost of hospitalization for these patients is
$27 344, nearly three times higher than for patients age 45-64.

Indigenous patients were found to be 30% more likely to be hospitalized for a dialysis-related infection. Overall, a patient on dialysis is most likely to require hospitalization during the first week of treatment.

Though the number of kidney transplants is also on the rise, it is not keeping pace with demand. In 2015, there were 1513 kidney transplants, up from 1426 in the previous year, according to the latest statistics from the Canadian Organ Replacement Register at CIHI.

“Kidney transplantation is not a cure, but it is the preferred treatment option for kidney patients over dialysis,” Elizabeth Myles, the national executive director of The Kidney Foundation of Canada, said in a media release. “In addition to providing improved health and survival, a patient’s quality of life is vastly better.”

The overall number of organs transplanted in Canada has seen a modest increase. There were 2570 organs transplanted in 2015, up from 2428 in 2014. During the same period, the number of Canadians waiting for an organ decreased (from 4514 to 4499), as did the number of patients who died on waiting lists (from 278 to 215). Kidneys made up the bulk of donated organs (1513), followed by livers (533), lungs (278), hearts (170) and pancreases (76).

“End-stage organ failure presents complex issues and challenges for Canadian patients, clinicians and health care systems,” states the report. “Treatment options continue to evolve, and organ donation practices and processes are continuously examined to optimize outcomes.”

Photo Credit: Picsfive/iStock

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