1. Presentation for Community Leadership
Diabetes, Blood Pressure & Kidney Health Checks & Care in Indigenous Communities
Presentation for Community Leadership

2. Kidney Health in Canada
1 in 10 Canadians has kidney problems
Almost 1 in 3 First Nations adults have kidney problems
15% of First Nations children showed signs that kidney problems were starting
Diabetes & high blood pressure are the leading causes
There is increasing kidney failure and use of dialysis over the last 20 years

3. Kidney Health in Manitoba
2012
2024
2015 report predicted rapid growth of dialysis and transplant patient populations
Between 2010 and 2017, Manitoba’s dialysis patient population grew by almost 35 per cent. 6

4. Kidney Health in Manitoba
More impact on central & northern Manitoba
The Kidney Care team wants to bring more PREVENTION efforts to these areas 6

5. Kidney Health & Indigenous Communities
The health of Indigenous people in Canada has been impacted for many reasons:
Some communities were relocated from traditional territories and practices
The legacy of residential schools
Mistreatment by western health systems
Lack of access to health care
Structural racism/poverty

6. Getting & Keeping Kidneys Healthy
First Nations people are impacted by chronic kidney disease (CKD) and end-stage kidney disease
How can we work together to help improve health
How do we help keep kidneys healthy so people don’t have to leave for dialysis
How do we prevent kidney failure

7. Bringing kidney, diabetes and blood pressure testing to rural and remote Indigenous Communities in Canada
Mobile health-care teams do the testing that provides on-the-spot results for adults and kids
Test results provided right away
A kidney health plan is created
Follow up care is arranged, if needed

8. Why Kidney Health Screening?
Results in under 1 hour
Find kidney problems early
Find & treat risk factors
Treatment to keep kidneys working
PREVENT or delay dialysis

9. Who Should be Screened? Kids ages 10 - 18 All adults
Health problems that can lead to kidney damage can start at younger ages
All adults
Unless already being treated by a kidney doctor

10. What’s Involved? Meeting with Community leadership
Community talk and youth engagement about kidneys and diabetes, blood pressure
Kidney, diabetes & blood pressure checks
Kidney health plan/follow up care
Report back to community

11. Indigenous Leadership & Partners
Using First Nation organization developed and implemented model of care (Diabetes Integration Project)
Working with people with lived experience with kidney disease working as partners on the project
Community leadership and community members help guide plans and set priorities for their community

12. Manitoba Partners Participating Communities
CanSOLVE CKD & Indigenous Patient Engagement Research Council Members
Diabetes Integration Project – First Nations Health & Social Secretariat of Manitoba
Chronic Disease Innovation Centre – SOGH
Manitoba Renal Program
Kidney Foundation of Canada Manitoba Branch
Research Manitoba
Children's Hospital Research Institute of Manitoba
Four Arrows Regional Health Authority

13. Testing Process

14. Point of Care Testing
On site results using portable equipment & custom-built app

15. Results: Risk Based

16. Follow Up: Team Approach
Low Risk Patients
Team:
Primary care provider
Focus:
Lifestyle
blood pressure
Medium Risk Patients
Team:
Primary Care providers
Kidney specialist
Focus:
Diagnosis
Lifestyle
Blood pressure
Protein leak reduction
High Risk Patients
Team: Multidisciplinary Kidney Health Clinic
Primary care provider*
Kidney specialist
Kidney Nurse
Kidney Dietitian
Kidney Pharmacist
Kidney Social worker
Focus:
Healthy Lifestyle
Reduction of blood pressure
Reduction of protein leak in the urine
Treat consequences of low kidney function
Treat related heart and diabetic diseases

17. Possible Treatments/ Kidney Health Plans
Healthy Lifestyle
Diet and exercise
Traditional Diets/Medicines?
Reduction of blood pressure to less than 130/80
Low salt diet
Medications
Reduction of protein leak in the urine (proteinuria)
Medications - ACE inhibitors and ARBs
Treatment of consequences of low kidney function
Low red cell counts (anemia)
Low calcium and high phosphate and potassium
Treatment of related diseases
Risk factors for heart disease
Sugar control in diabetics
SGLT-2 inhibitors

18. Changing Kidney Health Outcomes
before
Focused efforts on prevention and early treatment make a difference and can improve health outcomes.
(Graph: U.S. implemented kidney health interventions for American Indian populations)
after

19. Screening Results in Children
Screening for kidney disease in indigenous Canadian children: The FINISHED screen, triage and treat program

20. Kidney Health Plan to Change your Chance of Kidney Failure (Click to animate)
No Current Risk
Low
Intermediate
High

21. Diagnosis & Treatment = Prevention

22. What we need to know:
What we may need from the community to facilitate screening: taking appointments, transport, moving equipment, space for equipment/screening, etc.
How to engage community members to get tested, any potential barriers?
Best ways to screen children/get consent
Timelines

23. Next Steps Now/ASAP: Chief & Council Support
Discuss Support Needed from Community
Health-care staff / stakeholder meeting/presentation
Dates/times/space for screening clinic
Community meeting / kidney health fair to engage community
Future:
Kidney Check screening event
Report back to community
Demonstrating effectiveness & cost-efficiency of kidney health screening in First Nations communities for long-term funding

24. Questions?