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Turning the tide


Coordinated strategy helps slow growth of end-stage kidney disease

End-stage kidney disease is a condition best avoided if possible. The mortality rate for the disease is worse than for all cancers except lung cancer. What’s more, the need for dialysis several times a week is a difficult adjustment for many patients and affects quality of life.

Ten years ago, the number of people in BC being diagnosed with end-stage kidney disease and needing life-saving dialysis was growing by 16 percent a year. And at $45,000 a year per patient for dialysis, the ballooning cost of expanding those services was becoming a major concern.

Responding to these issues, in 2003 the BC Renal launched a strategy to identify BC renal patients at an earlier stage of their disease – before symptoms have developed. The agency’s research suggested that if these patients were given treatment and helped to manage their condition it might be possible to slow or stop progression of their disease and avoid the need for dialysis.

Dialysis growth rate lowest in country

To enable early identification of kidney disease, the agency worked with medical labs across the province to develop a standard measure of kidney function revealed through blood tests. The agency then engaged BC’s family doctors to make sure they understood how to interpret these test results and to recognize the signs of early kidney disease. It also funded the creation of kidney clinics across the province, to offer education and treatment for patients with early-stage kidney disease.

As revealed through ongoing data collection and research analysis, the results of this initiative – the largest of its kind in North America – have validated the agency’s assumptions and surpassed its expectations. By 2006/07 the annual dialysis growth rate in BC had fallen to five percent, the lowest rate in the country. The rate currently stands at just three percent. Over the past two years alone, this reduction in the growth of end-stage kidney disease has resulted in the agency avoiding $5.5 million in provincial dialysis costs.

Cost avoidance is only part of the story

Far more important for patients like 69-year-old Tegla Jones of New Westminster, is the success of the Renal Agency’s efforts in helping him manage his kidney disease and avoid dialysis.

“My kidneys are only operating at 28 percent at the moment, but that’s better than they were before,” says Jones. “Basically it’s diet and exercise that have been the big factor in keeping my kidneys functioning. In fact my doctor says the way I’m going now, I will probably never need dialysis.”

Fifty five-year old Jim Dunsmore of Coquitlam is even more blunt in crediting his kidney care team for preserving his health. “Without the help of my doctor and regular visits to the kidney care clinic over the years, I have no doubt that I would be a lot sicker today and possibly even dead,” says Dunsmore. Instead, Dunsmore has been able to continue working and enjoys a normal active life that includes ballroom dancing, travel and “an addiction to golf.”


SOURCE: Turning the tide ( )
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