The future of kidney disease research in Canada

Dr. Norman Rosenblum, Scientific Director, CIHR Institute of Nutrition, Metabolism and Diabetes (INMD), is a professor of pediatrics, physiology, and laboratory medicine and pathobiology at the University of Toronto, and a pediatric nephrologist and senior scientist at the Research Institute of The Hospital for Sick Children (SickKids). He is the recipient of a Tier I Canada Research Chair in Developmental Nephrology.

Why did you become a kidney researcher?
I continue to be fascinated by the kidney because it is an elegant and complex organ that consists of many different types of cells with very specialized functions. These cells are organized in a highly patterned, three-dimensional framework that is critical to the function of the kidney and, indeed, overall health.  The kidney performs many different tasks including filtering and reabsorbing different chemicals in the body in precise amounts. My research is inspired by the clinical care I provide at Sick Kids Hospital in Toronto. Abnormal kidney formation, is the major cause of childhood renal failure.

What is Chronic Kidney Disease (CKD)?
Kidney disease describes a variety of diseases and disorders that affect the kidneys by attacking the filtering units of the kidneys and damaging their ability to eliminate wastes and excess fluids. Kidney disease can range from mild to severe and in some cases, lead to kidney failure. Kidney disease often starts slowly and develops without symptoms over a number of years, so Chronic Kidney Disease (CKD) may not be detected until it has progressed to the point where kidney function is quite low. There is no cure, but it may be possible to prevent CKD or slow it down.

Who is affected?
According to the Kidney Foundation of Canada, in 2016 one in ten Canadians had kidney disease. There are a number of risk factors for CKD:

  • People with diabetes, high blood pressure or who have a family history of kidney disease are at increased risk of developing CKD.
  • Children who are born with kidneys that did not develop properly are also at risk.
  • In addition, people of Aboriginal, Asian, South Asian, Pacific Island, African/Caribbean and Hispanic descent are at higher risk for CKD.

Complications of Chronic Kidney Disease (CKD)

Kidney disease is common, and usually occurs in conjunction with other chronic conditions. It increases the risk of cardiovascular complications, is associated with severe symptoms, impacts a person’s quality of life, and can lead to kidney failure.

Adults who have unhealthy weights are at an increased risk of diabetes and high blood pressure, which are the two leading causes of kidney failure. In individuals affected by obesity, the kidneys have to work harder, filtering more blood than normal. Getting regular exercise and following a healthy eating plan can help maintain a healthy weight. A weight loss of even 5-10% of weight can have tremendous health benefits.

In addition to increasing the risk of heart attack, stroke, lung disease and cancer, smoking also increases the risk of kidney disease. Some non-prescription medications, such as non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen may damage the kidneys if used in large doses over a long period of time.

Future forward

Dialysis care costs anywhere from $60,000 to $100,000 per patient per year, which means the Canadian health care system spends nearly $2.5 billion annually caring for Canadians who are on dialysis. Dialysis also takes a toll on individuals and families. While outcomes for people living with kidney disease have improved over the last five decades, the basic approaches to managing and treating kidney disease have not changed significantly. While CIHR is funding an innovative patient-oriented research network, more research needs to be done.

Research opens the door to a better future for patients living with kidney disease, and for their families. Continued investments in research, collaboration between academic researchers, the clinical community, healthcare policy makers and patients is necessary to prevent kidney disease and improve outcomes and quality of care for patients with kidney disease.

Dr. Norman Rosenblum, MD, FRCPC
Scientific Director
CIHR Institute of Nutrition, Metabolism and Diabetes

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