How Common is Diabetic Kidney Disease? - The Scarborough Hospital - Chronic Kidney Disease Program

How Common is Diabetic Kidney Disease?




About 30 to 40 percent of people who have
type one diabetes will have kidney disease.
About 20 to 30 percent of people with type
two diabetes will have kidney disease. Now,
not all of them will progress to kidney failure,
requiring dialysis, or transplantation, which
is everybody's biggest fear when they come
to see me. Some will, and it's very important
to diagnose these people early and to treat
them early.

https://www.youtube.com/watch?v=Jzv49NJlcX0


The Scarborough Hospital - Chronic Kidney Disease Program




The Scarborough Hospital Regional Program
is very unique as it remains in-centre in
the hospital. We have three other satellites.
We have one sattellite specifically in a chronic
care hospital so we can dialyse people right
in the hospital so we don't have to ship them
out. We have three, what we call home-units,
actually in nursing homes so patients don't
have to leave the nursing home to be dialyzed.
And this is the work we want to do -- preventative
work so hopefully they never have to get on
to dialysis.
Our program is called the Chronic Kidney Disease
Program. The majority of our patients that
come to us are not on dialysis, and we are
the first ones who see the patients as they
come into the program. Usually when they come
see us they see a nurse and a dietitian or
a diabetes nurse specialist. We give them
the tools and the strategies to keep their
kidney function working well.
What we do is we try to give the patients
enough equipment, tools, information to let
themselves direct their care as they're in
the community. Remember these patients are
not sick, they're not in the hospital -- they're
in the community.
We just want them to be independent, so if
we can keep that kidney function good we can
prevent them from going on to the next stage.
It's much more cost-effective to treat them
as an outpatient and prevent them from being
admitted to the hospital.
We are at the north wing of hemodialysis right
now. The hospital location of hemodialysis
hosts about 300 patients every two days, every
48 hours. We are at the point where we are
over capacity. To actually offer a patient
a dialysis treatment it's over $100 dollars
just for one treatment. And that's something
a lot of patients need at least three times
a week -- dialysis.
Having a community satellite dialysis unit
is so important for the patients. The challenge
that we have here, as you can see, is actually
tightness of space. Being here the patient
has the flexibility of working during the
day and then in the evening come here for
their dialysis treatment.
I started dialysis here in 2006, in February.
Thank God we have dialysis here -- I'm still
alive today. It's something good. Today I'm
doing dialysis and I don't do much, but the
next day is normal. Go out for coffee, go
out with my wife. I have no problem. I feel
stronger. We're all one big family here. I
know all the nurses and they know everyone
around. It's very nice.
The nursing staff here are excellent. They
provide the best of nursing care to the patients.
So having a community dialysis setting it
actually helps to accommodate their everyday
lifestyle. So my ideal dream would be to build
a unit where it's more spacious to prevent
any kind of cross contamination between patients.
This is the Yee Hong hemodialysis unit, one
of the three satellite sites The Scarborough
Hospital has. It's the same size as the other
dialysis unit, but as you can see it's quite
spacious in between each dialysis machine
and ultimately this would be the gold standard
of a hemodialysis unit.
You're here three times a week, four hours
a day. This place here, this is the best place
to be. It's quiet, it's clean, it's spotless.
The nurses can't do enough for you. They bend
over backwards for you to explain things and
the way they treat you is fantastic.
A lot of the doctors look after patients who
come to them when they have a problem. It's
very episodic. For us, we are kind of married
to our patients. When they start to have a
problem, they get on dialysis and we follow
them through. They come and interact with
us when they are well, and we look after them
when they are sick. We suffer with them emotionally
and we feel happy with them when things are
going well. If we can build a home-base for
doing all the things that we can do, that
would be very, very fulfilling.
I would never have thought before that I'd
be here, but the thing is you have to go through
something like this and you realize yes, you
can help people and that life is good if you
can help somebody. I don't know, you go around
and you see a lot of young people, they go
through that. It's not nice.

https://www.youtube.com/watch?v=PcPCXQe8i0I