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Ten-Year Outcomes of End-Stage Kidney Disease

THE NUMBER of Canadians living with end-stage kidney disease (ESKD) is on the rise, having increased by 35% from 2008–2017, affecting >38,800 people (not including patients from Québec); as a result, this condition is highly pertinent. A comparison of dialysis and kidney transplants, based on Canadian data, has shown there are major differences in long-term outcomes between the two treatments in individuals with ESKD. The Canadian Institute for Health Information (CIHI) released 10-year outcome data on the two treatments. The data showed that up to 74% of Canadians who received a kidney transplant still had a functioning kidney a decade after the surgery, while 84% of Canadians on dialysis did not survive >10 years. It is worth highlighting that patients who had their transplanted kidney begin to fail would still have had the treatment option of dialysis.

Closer analysis revealed that age was also a major factor in determining the outcome of ESKD treatment. Of those Canadians aged from 18–44 years at the onset of dialysis, 51% survived past 10 years. The corresponding figure for those aged 65–74 years was 12%. A similar trend was observed for 10-year kidney transplant outcomes. The percentage of Canadians receiving a transplant who had a functioning kidney after 10 years was 80% for those aged 18–44 and up to 64% for those who were >65.  Additionally, kidneys donated by deceased donors tended to function effectively for less time than kidneys transplanted from a living donor.

There was an increased trend of deceased organ donations from 2008–2017, with a 51% increase; however, the rate of living donation decreased by 11%. At present, 4,333 patients are on the waiting list for a kidney transplant. With this shortage of donated kidneys, the data makes it even more imperative to design policies that encourage organ donation.