By Dr. Adeera Levin: Our health system has historically focused on managing end-stage disease rather than preventing it
Chronic kidney disease affects millions of Canadians, yet it rarely commands the public attention given to other chronic illnesses.
Often progressing silently until advanced stages, it carries a heavy toll for individuals, families and the health-care system — particularly for Indigenous Peoples and other populations facing social and economic barriers. Indigenous communities in Canada are three to four times more likely to develop chronic kidney disease.
The sad truth is that much of this burden is preventable. In Canada, advances in research and a deeper understanding of how social determinants shape health outcomes mean we know more than ever about what works to improve kidney health. The challenge is acting on what we know.
In 2025, the World Health Organization passed a formal resolution calling on countries to strengthen awareness, prevention, early detection and health system responses to chronic kidney disease. Yet in practice, kidney disease is still too often detected late, when treatment options are limited and costly.
Our health system has historically focused on managing end-stage disease rather than preventing it. Decades of research show that early detection, culturally safe care and community-centred approaches can slow or even prevent disease progression, but these approaches aren’t consistently embedded in routine care.
One example of how evidence can be translated into action is Kidney Check, a mobile, community-led kidney screening program operating in First Nations communities in B.C., Alberta and Manitoba. Designed in partnership with communities, Kidney Check brings early detection directly to people who face barriers to accessing care. It demonstrates what is possible when research, lived experience and culturally safe approaches are aligned.
Importantly, Kidney Check isn’t simply a stand-alone project. It also offers practical lessons for how health systems can embed prevention and early detection into routine care, particularly for populations at highest risk. Similar initiatives across the country are generating evidence that can inform provincial and national policy decisions.
Progress is being driven by collaboration. National research networks, provincial renal programs, professional societies, organizations such as the Kidney Foundation of Canada, nursing and pharmacy groups, and Indigenous partners are working to close the gap between evidence and care. No single organization owns the solution — lasting change depends on co-ordinated action.
Canada’s kidney research community increasingly recognizes that health outcomes are shaped not only by biology, but also by where people live, their access to care and the conditions that influence health. Research that meaningfully includes patients and communities leads to more relevant, implementable solutions and helps ensure that innovation doesn’t deepen existing inequities.
As a nephrologist and researcher working alongside patients, communities and health systems across Canada, I see both the human cost of kidney disease and the growing opportunity to prevent it.
Treating chronic kidney disease as a preventable public health priority means integrating routine screening into primary care for those at risk, expanding access to medications that slow disease progression, supporting Indigenous-led and community-driven models of care, and embedding prevention into health policy before patients reach crisis. These are practical steps within reach — if we choose to make prevention a priority.
Kidney Awareness Month is an opportunity to move beyond awareness alone. We already know what works to improve kidney health. The question is whether we are willing to reorganize our system to do so.
Dr. Adeera Levin is principal investigator of Can-SOLVE CKD, Canada’s national kidney research network, the executive director of B.C. Renal, and head of the division of nephrology at the University of B.C.
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