Get Familiar with Kidney Health

Every single living creature on earth that has a backbone, known as vertebrates, also has kidneys.  Whether they live on land or under water, they are guaranteed to have kidneys, and some may even have more than others.  However, not a single one of these mammals, reptiles, amphibians, or birds can survive without functioning kidneys, which are as important as the heart and lungs.  The importance of kidneys might be best described as a filtration system pump that is required to filter the water to ensure the pipes are not flooded with dirty water and a balanced flow of water is pumping through the pipes that might otherwise burst if left uncontrolled.  An organ which is that common across species and as important as the heart and lungs should be worth getting familiar with – at least its presence in humans.

A quick overview of kidney health, symptoms, and treatment.

The kidneys tend to be best known for being a human organ that has a bean named after them, that comes in two, and that it plays a role in urination, or “the peeing process”.  That peeing process is part of a larger process called the excretory system, and the kidneys filter out waste which ends up getting peed out.  But that is not all that the kidneys do, their full capabilities include maintaining blood pressure, filtering blood, balancing water and electrolytes, producing hormones, and pumping out harmful substances and excess water from the body.  Without properly functioning kidneys, a person’s insides could swell with fluid and their skin would balloon, but those internal fluids would also be full of waste and toxins; it would be a nightmare and very painful.

Poorly functioning kidneys are not uncommon, and the most common kidney-related health struggles tend to be the result of genetic factors, but lifestyle outcomes like obesity and smoking, or even a physical injury, can damage them too.  The list of the most commonly associated kidney diseases includes chronic kidney disease, acute kidney injury, kidney stones, kidney infections, kidney cysts, and kidney cancer.  The challenges with these six kidney diseases are that they share similar symptoms like nausea, vomiting, loss of appetite, fatigue and weakness, metallic smelling breath, sleep or concentration challenges, puffy under-eyes, changes in urine output, darker-colored or smelly urine, foamy or bubbly urine, swelling of feet and ankles, muscle twitches and muscle cramps, and back, abdomen, or groin pain.

Since many of the symptoms are shared with other diseases, if doctors suspect kidney-related health struggles they will usually refer patients out for one of four tests: blood analysis tests, urine analysis tests, kidney imaging tests, or even a kidney biopsy.  The first two involve analyzing blood and urine for things like urea, creatine, calcium and other dissolved salts in blood, and protein in urine.  Kidney imaging tests typically start with ultrasounds aimed at identifying shape or position abnormalities, but CT scans are aimed at creating a 3D picture to identify structural changes or deformities.  Kidney biopsies, on the other hand, are invasive procedures that involve removing a small piece of kidney tissue to be examined under a microscope, and they are done while a patient is anesthetized and can be quite unpleasant.  But more unpleasant physical pain might be realizing how prevalent kidney disease is among Canadians and the burdening costs associated with it.

Canada has a kidney problem.

A 2017 report published in the Canadian Journal of Kidney Health and Disease found that health care costs attributable to chronic kidney diseases in Canada exceeded $40 billion per year, but more shocking than the high annual costs was the disparity in where the people with kidney disease tended to land on the socio-economic spectrum.  Data from Ontario indicated that 90% of patients with chronic kidney disease had an annual income of less than $30,000, and 45% of those had an annual household income of less than $15,000.  As concerning as that disparity in health outcomes should be, the overarching data related to kidney disease and organ donations might be just as troubling.

According to statistics provided by Kidney Foundation Canada, Canada has a serious kidney problem both with kidney disease but also with organ donations.  Kidney Foundation Canada’s statistics indicate that 1 in 10 Canadians has kidney disease, and the leading cause of kidney failure is the result of diabetes in almost 40% of all cases.  Since 2021, the number of people living with end-stage kidney disease has grown 31%, but 46% of new patients are under the age of 65.  The treatment breakdown is 57% on dialysis while 43% have functioning transplants, but 75% of those on dialysis are receiving institution-delivered dialysis, the most expensive form.  Worst of all, there is no cure for end-stage kidney disease and it has been ranked as the 10th leading cause of death in Canada.

On the organ donation side, 75% of Canadians on the waiting list for an organ transplant are waiting for kidney transplants, but only 10% of the people that are on dialysis are on the list for a kidney transplant.  Although the five-year survival rate for kidney transplants is high, the median wait time for a deceased-donor kidney transplant was just under 3 years, 9 months, with the shortest waits being in B.C.  (2 years, 9 months) and the longest in Manitoba (7 years, 2 months).  About 25% of kidney transplants are made possible by living donors, and more than 45% of all living donors were unrelated to the recipient.  As Canada’s aging population starts to develop chronic diseases at younger ages, there are troubling realities that we will need to come to terms with including what happens as the prevalence of diabetes continues to rise among Canadians and what happens if the number of unrelated donors starts to fall.

This past October, the Canadian Association of Journalists featured a fireside chat with acclaimed health reporter Wency Leung, where the topic of discussion was the rarity of organ donations, and to discuss an op-ed written by Wency where she wrote about her decision to donate a kidney.  One of the more surprising stats that was shared was that in 2019, pre-Covid, there were only 302 kidney donations by living donors in Ontario despite that it had a population close to 15 million.  Perhaps the question to ask in all of this is what organ transplant lists will look like if Ontario allows private clinics to offer tests to diagnose kidney disease, and if individuals who can afford to pay for kidney testing start to jump in front of individuals with limited financial capabilities, because 90% of patients in Ontario with kidney disease are unlikely to be able to afford any aspect of privatized health care services.

%d bloggers like this: