Health Research BC is providing match funds for this research project, which is funded by the Canadian Institutes of Health Research’s (CIHR) Strategy for Patient-Oriented Research (SPOR) Networks in Chronic Disease.
A British Columbia researcher is at the forefront of a coast-to-coast network of patients, health care providers, policy-makers, and researchers working to transform the treatment and care for the four million Canadians living with chronic kidney disease (CKD).
Dr. Adeera Levin, head of the division of nephrology at the University of British Columbia (UBC), and head of BC Renal Agency, is co-chairing the Can-SOLVE CKD Network with the University of Calgary’s Dr. Braden Manns and Dr. James Scholey of the University of Toronto. Based at Providence Health Care, Can-SOLVE CKD is Canada’s largest-ever effort to improve care for people with kidney diseases. The five-year initiative aims to reduce the number of people who need dialysis or organ transplants, or who develop debilitating or deadly related illnesses, costing the Canadian health care system more than $50 billion each year.
More than 120 investigators from across Canada are participating in 18 research projects based on key issues identified by patients over three years of priority-setting discussions. The projects are organized around three major themes: identifying CKD in high-risk populations; testing new therapies in those with progressive CKD to improve outcomes and quality of life; and determining how best to deliver innovative patient-centered clinical care, ensuring the right patient receives the right treatment at the right time.
CKD has a disproportionate impact on vulnerable populations of Indigenous people, children and the elderly and is linked to many chronic conditions including heart disease, diabetes and high blood pressure. The unique needs and perspectives of patients are represented through two governance bodies: a Patient Council and an Indigenous Peoples’ Engagement and Research Council that will guide all activities and decision making.
One of the best ways to treat kidney disease is to identify it early and take preventative measures to slow disease progression and reduce the need for expensive therapies like dialysis and transplantation. Yet many First Nations communities in rural and remote areas face barriers to adequate kidney health screening and care. Within the Can-SOLVE CKD Network, our Kidney Check program aims to address this problem by supporting First Nations communities to implement local kidney health screening.
Using culturally safe practices, trained staff perform point-of-care screening and risk prediction in Indigenous communities. Individuals receive instant feedback on their personal level of risk for kidney disease, high blood pressure, and diabetes. They participate in creating a personal kidney health follow-up plan that may include counselling, treatment recommendations, an appointment with a doctor, or direct referral to a kidney specialist. With correct treatment and continued follow-up, the number of Indigenous people with chronic kidney disease will decline and fewer patients will progress to kidney failure requiring dialysis.
Prior to the temporary cessation of screening in March 2020 due to the COVID-19 pandemic, the BC Kidney Check team members screened 133 individuals in 11 communities across the province.
Local implementation in BC was supported through a collaboration between 16 First Nations, the First Nations Health Authority, First Nations Leadership, First Nations physicians, nurses, community health directors, Indigenous health care providers, primary care providers, Indigenous patient partners, and nephrologists.
As a result of the Kidney Check program, screened individuals determined to be at risk of or living with chronic kidney disease have been referred to nephrologists. Such early intervention has the potential to lower long-term health care costs, and provide these individuals with better health outcomes and quality of life.
Critically, Kidney Check is building capacity in First Nations communities to control their own health care, through general education and real-time access of the kidney health status of individuals. The benefits of this program cannot be quantified by numbers alone. Catherine Turner, Senior Project Coordinator of BC Kidney Check, says, “The service is provided in a culturally safe environment, usually held in the community Health Centre, leading to improved relations as well as a greater trust in the health care system.”
The Kidney Check team has adapted the screening model to a virtual method in response to the COVID-19 pandemic. Under the virtual model, screening can be conducted by community nurses who are appropriately trained. The Kidney Check team has developed a virtual training program which has already been successfully implemented for several First Nations communities. Using this model, screening will resume in fall 2021 with the project team aiming to eventually screen 1,000 individuals.