Renal
Transforming care for people with kidney disease
As a leader in the research and treatment of chronic kidney disease, St. Paul’s Hospital is setting national standards for renal care.
One in 10 Canadians has kidney disease – that’s about 4 million people – and those numbers are rising due to our aging population, along with higher rates of diabetes and hypertension.
Kidney disease is a lifelong, debilitating condition that affects a person’s physical and emotional well-being, ability to work, and relationships. Patients whose kidneys are failing typically require a transplant and often experience months or years of dialysis before a donor kidney is available.
Today, people with kidney disease require specialized care for life. Providence is a global leader in multidisciplinary kidney care, backed by a team of more than 200 people.
- The kidney transplant program at St. Paul’s Hospital, collectively with VGH, is the largest kidney transplant program in Canada and among the 10 largest programs in North America
- In 2023, the team completed 108 kidney transplants
- St. Paul’s has the highest survival rates of in-centre dialysis patients in BC and one of Canada’s highest independent dialysis rates
- The living kidney donor program at St. Paul’s is the largest in Canada and we’re recognized as a national leader in living donation policy and practice
- St. Paul’s has performed unique transplant procedures in BC, including kidney swaps (where a donor whose kidney isn’t compatible with a loved one agrees to donate to a stranger, with the expectation that their loved one will receive a kidney from another stranger in return) and blood-incompatible transplants between donors with different blood types
- The Clinical Kidney Transplant Research group at St. Paul’s Hospital is the largest of its kind in Canada, with research spanning health policy, health services, clinical trials, health economics, women’s health, Indigenous health and equity based research, and translational research in immunology and therapeutics
“Because of St. Paul’s – because of generous donors – I am a two-time kidney transplant recipient and a mom with two healthy daughters,” says Hayley Atkinson. “Right from the get-go, they weren’t just treating my disease, they were treating me and the life I hoped to have.”
Although her journey to motherhood and good health has not been easy, Hayley Atkinson is grateful for one constant: the life-changing care she’s received at St. Paul’s Hospital.
Kidney Program at St. Paul’s Hospital
St. Paul’s Hospital’s kidney disease services have set an international benchmark for excellence and innovation.
St. Paul’s Hospital is part of the largest provincial transplant program in Canada and is an international leader in the research and treatment of chronic kidney disease.
The Kidney Program has set a national standard for research, medical education, and care, developing research objectives and treatment protocols that focus on the patients’ expectations for quality and quantity of life. We’ve developed and tested new models of kidney care that are now used around the world.
We’re leading kidney care and education with the creation of non-surgical fistulas, working with donor kidneys that would not typically be used for transplantation, and engaging patients so that research and clinical care decisions reflect patients’ goals, needs, and desires for an improved quality of life.
Offering a range of integrated inpatient and outpatient services, the program serves many of the 18,000 British Columbians receiving care for kidney disease.
The Kidney Program includes:
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The Kidney Care Clinical Program supports individuals and families living with kidney disease to slow or stop the rate of kidney decline, and to prevent the need for therapies such as dialysis or kidney transplant.
The Integrated Care Clinic, the first of its kind in Canada, is a central hub of sub-specialty services for people living with multiple conditions (up to 40% of people with diabetes and 35% of those with heart disease also have kidney disease).
Supports and services include:
- Diabetes care
- Kidney obstetrics
- Glomerulonephritis Clinic
- Kidney Transplant Clinic, which includes pre- and post-transplant clinics that offer integrated care from endocrinology and dermatology
- Nutrition coaching
- Social worker counselling
- Teaching and training by nurse patient educators
- Advice on medications
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Kidney transplantation is the preferred treatment option for most people with end-stage kidney disease. The Kidney Transplant Program at St. Paul’s offers:
- Pre-transplant referral and assessment services
- Transplant surgery
- Post-transplant care
- A variety of living donor programs, including a kidney paired exchange program
- A deceased donor program
The Kidney Transplant Program works closely with several key partners, including BC Transplant, the BC Renal Agency, Canadian Blood Services, and the Provincial Health Services Authority.
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This innovative exchange program increases the donor pool by giving people who are unable to receive a kidney from a loved one the chance to receive a transplant from other donors.
Here’s how it works: let’s say you’d like to donate a kidney to a family member, but you aren’t a match. Another family on the registry is in the same situation. If the transplant candidate in the other pair is a match for you, and their donor is a match for your loved one, swapping donors is a life-saving solution.
Since the registry began, more than 1,000 donors and recipients have been matched across Canada. That’s 1,000 fewer people on the donor waiting list. That’s 1,000 people who will not need dialysis.
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St. Paul’s Hospital provides clinic-based hemodialysis in the hospital and eight community dialysis units across BC. The In-Centre Hemodialysis (HD) unit at St. Paul’s is one of the largest in BC and is the only centre in Western Canada offering plasma exchange (TPE) and combination therapy (simultaneous HD and TPE) for those who need it.
Eligible patients are trained to manage their hemodialysis treatments at home, giving them more control over the location, timing, frequency, and duration of their treatments.
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The kidney research team at St. Paul’s Hospital plays a leading role in CanSOLVE-CKD, a Canada-wide initiative. Working in partnership with patients, researchers, health care providers, and policy-makers, CanSOLVE aims to put patients first and overcome the challenges preventing research evidence from being put into clinical practice.
The team studies the effect of the disease and treatments on individuals, systems such as models of care for chronic conditions, and new ways of accessing transplantation and transitioning to dialysis.
They are also working to bring about cultural changes to make patient participation in research the norm. With international partners, the team is participating in research aimed at delaying disease progression and accessible cures for certain types of kidney disease.
A walking miracle
When he was first diagnosed with kidney failure, Darrell Epp wasn’t expected to live 18 months.
That was in 1982. He is thought to be one of the world’s longest-surviving dialysis patients.
In the years since, he has had two failed kidney transplants, one successful transplant that gave him 10 “priceless” years, and untold hours of dialysis.
Today, Darrell calls himself a “walking miracle.” Despite spending so much of his life at St. Paul’s Hospital, Darrell says there’s a silver lining: the close bond between the patients and staff. “The nurses were like family. We talked about everything. We even got invited to their Christmas parties, retirements, and social events.”
A healing journey
When Ken Wilson first took ill with kidney disease, he travelled back and forth between St. Paul’s Hospital and his home in Bella Bella. The care was excellent, but the journey was long. Ken wanted the opportunity to have home dialysis. The Kidney Program made it happen, yet soon it was clear that what Ken really needed was a kidney transplant.
Ken returned to St. Paul’s Hospital to receive his new kidney in 2017. Afterwards, he was able to go out on his skiff and spend time with his wife, five children, and 12 grandchildren. He recalls a moment at St. Paul’s after his transplant when he was surrounded by his medical team. “I told them how grateful I was for their care, and how happy I am to have this second chance.”
Discover how your support can change lives for people living with kidney disease.
Breaking down barriers to kidney care
We’re working to remove barriers to specialized kidney care so that all British Columbians can benefit equally from expertise at St. Paul’s Hospital.
When individuals in rural or remote communities are confronted with kidney failure, their lifeline often becomes self-administered dialysis.
While many dialysis expenses are covered, a critical gap is often overlooked. As part of their treatment, patients must travel to Vancouver and stay somewhere close to St. Paul’s for several weeks to receive their training for dialysis.
Since the costs of travel, accommodation, and meals are not covered, these expenses place a significant financial burden on patients.
Our solution: the Renal Community Fund.
This fund alleviates the burden endured by kidney patients who must travel for essential dialysis training by covering their travel expenses, accommodation, and meals – so they can focus on their health.
The positive impact of this support cannot be overstated: many patients have candidly shared that without this assistance, they would have faced insurmountable challenges.
A first-of-its-kind scholarship
Revolutionizing patient care with the Angus Rae Scholarship in Indigenous Health
Due to unfair inequities in health care access, Indigenous Peoples in Canada experience kidney disease at rates up to five times higher than the general population. According to reports by the Canadian Institute for Health Information, First Nations, Inuit, and Métis Peoples are more than three times as likely to need treatment for end-stage kidney disease and are four times as likely to travel long distances for treatment.
The roots of this trace back to colonialism, centuries of substandard health care, and inadequate infrastructure in remote areas. Social determinants of health such as poverty, education, and substandard housing further exacerbate the burden of kidney disease. Indigenous communities continue to lose precious elders, community, and family members to the disease.
The Angus Rae Scholarship in Indigenous Health is a transformative initiative. It aims to create a network of kidney health providers in BC specifically trained in culturally safe care to support the needs of Indigenous Peoples in partnership with their trusted local health providers.
The scholarship is named for Dr. Angus Rae, an eminent nephrology pioneer at St. Paul’s Hospital who dedicated himself to serving the priorities of Indigenous communities in BC, leaving a profound impact that extended beyond medicine.
He advocated for cultural safety, encouraging ceremonies within the renal ward to nurture patients’ spirits, long before this was supported within hospital environments.
The objectives of the Angus Rae Scholarship are:
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Remote and rural areas struggle to access vital health care. Virtual health tech empowers scholarship recipients with lifeline access to kidney specialists, ensuring timely support.
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We aim to raise kidney disease awareness among local Indigenous communities, promoting prevention and individual empowerment. By engaging with trusted partners in home communities – such as Elders, patient partners, trusted local health, and social service providers – we can help prevent health disparities for Indigenous Peoples across BC.
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The Angus Rae Scholarship will circulate knowledge through lectures and learning experiences for nephrology trainees. Shared knowledge enhances patient care and fosters culturally informed health care.
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Our commitment goes beyond kidney care. The scholarship's success will pave the way for an expanded model of care, encompassing other medical subspecialties. This ripple effect of change embraces all generations and subspecialties, acknowledging the human aspect of this health care crisis.
The path forward
Our vision for the future of kidney disease and renal care
We aim to improve access to care, ensure every qualifying patient can get a kidney transplant before they require dialysis, and partner with patients to develop individualized treatment options.
Imagine a future where every person diagnosed with kidney disease has easy access to the resources needed to treat their condition, ideally without the life-altering side effects of dialysis. Should the disease progress and transplantation become necessary, patients wait only briefly for a new kidney.
Imagine the financial burden of kidney disease being no greater for an individual who lives in a remote area than for someone who lives next to a treatment centre, and when geography, socio-economic status, and ethnicity do not stand in the way of outstanding care.
Imagine when the idea of donating a kidney is as widely accepted as giving blood. When regenerative medicine enhances the kidney’s ability to repair itself.
Imagine when all aspects of clinical care have a direct connection to research, which then has a rapid impact on the quality of life for patients.
This future is swiftly becoming the present in the hands of the renal team at St. Paul’s Hospital.
A new home for kidney care
The future of kidney care at the new St. Paul’s Hospital on the Jim Pattison Medical Campus is one of easy and equal access to care. It is a model that:
- Is flexible enough to put patients first and allow for highly individualized treatment plans
- Establishes a culture shift that moves living-donor kidney transplants into the mainstream
- Provides the research leadership needed to develop innovative care options for patients
- Offers training programs for the next generation of caregivers
We’re bringing this model to life at the new St. Paul’s Hospital.
Kidney Program services at the new St. Paul’s will offer integrated prevention and treatment for patients living with kidney disease across BC and the Yukon.
The proximity of research labs and offices to the new hospital will support the close integration of research and clinical care, enhancing the Kidney Program’s established collaboration with other departments.
Patients in the kidney program often require more than one service during each visit. At the new St. Paul’s Hospital, they will be able to move seamlessly from one department to the next.
The Dialysis Centre, Vascular Access, the Kidney Care Centre, Kidney Transplant Clinic, each of which offers outpatient services, and the kidney inpatient unit will be located on the same level for easy access and transition.
Read more
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Transforming kidney care by putting patients first
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Building a bridge to better, healthier lives
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Indigenous Canadians help change kidney care for their communities
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Scott Canning’s journey to a new kidney, and to a new chance at life
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Yet another new lease on life
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A mother’s gift. A life saved. A family held together.
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St. Paul’s kidney-patient dragon boat team races in Hong Kong
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St. Paul’s leading the way with innovative kidney transplant pairing program
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