Seven Oaks wins award for kidney program

WINNIPEG – The Chronic Disease Innovation Centre at Seven Oaks General Hospital, along with the University of Manitoba, have gained international recognition for Kidney Check, the next generation of surveillance for hypertension, diabetes and chronic kidney disease, with a special focus on First Nations peoples.

The partners were honoured as a North America Global Winner of the UNIVANTS of Healthcare Excellence Award, which recognizes teams that collaborate across disciplines and transform healthcare delivery, ultimately improving patient lives.

The UNIVANTS of Healthcare Excellence Award was created by Abbott and leading healthcare partners around the world. www.univantshce.com/int/en/2020-winners

Many First Nations people face significant obstacles in gaining access to preventative care, due in many cases to geographical challenges associated with remote communities. This has led to an unusually high rate of kidney failure within these communities, with some rural and remote regions recording a 10- to 20-fold increase in recent years.

Hoping to address this major obstacle in care and to emphasize kidney health, a multidisciplinary team of experts in nephrology, biochemistry, Indigenous Health and technology in Winnipeg have embarked on an effort to increase kidney disease awareness and screen and treat as many Indigenous people for chronic kidney disease (CKD) as possible.

The team discovered that almost a third of Indigenous patients had some degree of kidney disease – significantly more than Canada’s overall population, which has an incidence rate of only 10 to 12 percent.

“It’s easy to detect, easy to test for and it can be prevented, but these people are often getting suboptimal preventive care,” said Dr. Paul Komenda, an academic nephrologist at the University of Manitoba and research director at Seven Oaks General Hospital’s Chronic Disease Innovation Centre. (Photo was digitally composed to align with public health direction on COVID-19.)

The team’s solution, Kidney Check, leverages point-of-care testing and an algorithm-informed tablet app used by nurses that analyzes diagnostic values and advises on necessary follow-up according to individualized risk of CKD progression. Although the leadership team includes First Nations clinicians, not all frontline caregivers were a part of this community, so training for nurses and other team members emphasized cultural safety and a rebuilding of trust.

“Being authentic means you have to respect local protocols while being present and persistent,” Dr. Komenda said. While dialysis can’t necessarily be avoided, early intervention can delay the need for dialysis by several years in some cases, especially with the advent of newer therapies.

This is significant, as dialysis can have a life-changing impact on any patient, especially First Nations residents and their quality of life. In some cases, the need for dialysis may require patients to relocate away from their traditional communities and support networks.

Dialysis accounts for nearly all healthcare dollars for kidney disease, so prevention is expected to result in significant downstream cost reduction. The typical cost of dialysis in Manitoba is $60,000 to $80,000 CAD per patient per year, but can be as high as $200,000 CAD per patient in remote northern regions.

The program, which is expanding to other provinces, will ultimately reach thousands of adults and children. The pilot program has already screened 1,700 people across 11 communities, 68 percent of whom were identified as high risk for cardiovascular disease, diabetes or chronic kidney disease.

Personalized kidney health plans were provided to all screened patients with those at higher risk referred directly to Seven Oaks Hospital.