March 12, 2025

Across Canada, health care systems are struggling to deliver quality and timely care to those who need it most, but there are success stories — often from programs operating at the community level — that offer insights we can learn from.  

One such initiative is Kidney Check, a point-of-care screening program that has helped provide thousands of people living in rural and remote Indigenous communities access to early testing for kidney disease. The award-winning program, operating in Alberta, BC, Manitoba, and Ontario, offers numerous benefits, from providing individuals with a higher quality of life to lowering long-term health care costs.  

We spoke with Dr. Paul Komenda, project lead for Kidney Check in Manitoba, and patient lead Cathy Woods of Naicatchewenin First Nation, about how the program began, how it’s been received in Manitoba, and why this community-centred approach to kidney screening is so valuable.  

Understanding the need for screening and early detection in Indigenous communities  

Kidney disease often does not show symptoms until it has progressed to an advanced stage. As a result, many people may not know they have kidney disease until they have severely reduced kidney function, at which point dialysis — or a kidney transplant — may be needed. The good news is that simple blood and urine tests can reveal kidney function issues early on. If detected early, it’s possible to slow the progression of kidney disease and prevent the onset of kidney failure.  

Due in large part to social determinants of health and the lasting impacts of colonialism, Indigenous people in Canada are approximately three times more likely to experience kidney disease than the rest of the Canadian population, and their health outcomes may be worse if they live in rural or remote areas, where access to care is especially challenging. Often, people in these communities must leave their homes and families behind and incur travel expenses to receive the treatment they need. 

The Kidney Check program is based on FINISHED, a diabetes screening program that was a partnership between the First Nations Health and Social Secretariat of Manitoba‘s Diabetes Integration Project and the Centre for Health Innovation, funded by the Health Services Integration Fund. Kidney Check brings kidney disease screening to rural and remote Indigenous communities, with local or visiting nurses (and sometimes both) conducting simple blood and urine tests and providing results, kidney health information, and treatment recommendations all in one visit. As a result, some of the people most affected by kidney disease can benefit from early detection and learn about ways to slow disease progression — for example through lifestyle changes and medications.  

Looking at the benefits of Kidney Check 

The main goal of Kidney Check is to make it easier for communities at higher risk of kidney disease to access recommendedcare for early kidney disease or risk factors in a way that is inclusive and equitable, and that recognizes and integrates cultural approaches and history into care. This respectful community-centred approach to program delivery ensures that every participating community determines how the program is implemented locally, so they receive care that aligns with their values and needs. Indigenous people with lived experience of kidney disease helped design and implement the program.  This includes Woods, who is the lead patient partner helping to guide the implementation of Kidney Check.  

“It’s a well-developed program that’s constantly being updated, and it’s well worth the time and the dollars that have been spent on it,” says Woods, emphasizing that she would like to see all Indigenous communities who want to partake in the program have access to it. “It needs to be in the hands of those who need it most.” 

Woods’ own kidney disease was caught early, thanks to routine testing. “When I was diagnosed, I had no symptoms that would have led me to go to a doctor,” she says. But because Woods’ kidney disease was caught early, and it was a treatable form of kidney disease, she managed to make a full recovery.  

Not only does Kidney Check help people get treatment sooner, but it can also be cost-effective in the long term, as shown by an economic analysis conducted by Dr. Komenda and others. This is because the costs associated with advanced kidney disease, especially if someone in a rural or remote area requires dialysis, are very high. Dr. Komenda notes that even more therapies to prevent kidney disease progression have emerged since that study was published in 2017, meaning the economic benefits of Kidney Check have only increased in recent years. 

“This is a highly cost-saving intervention now, so I think it should be just standard of care that we do Kidney Check in high-risk communities, especially Indigenous communities,” he says.  

After being positively received by Indigenous communities in Manitoba, the program has gained significant traction in recent years. The Can-SOLVE CKD Network took on the program in 2016 and expanded it to include communities in BC, Alberta, and Ontario. Dr. Komenda notes that it has been adapted over time, and especially in response to COVID-19 when many Indigenous communities weren’t accepting visitors. 

“We had actually spawned an additional program called Virtual Kidney Check, which is ongoing right now,” says Dr. Komenda. In the virtual format, either informational materials about kidney disease or requisition forms are mailed out to Indigenous people in Manitoba, the latter of which refers people to receive kidney health tests. If test results indicate kidney disease, individuals are then referred to a kidney care specialist.  

Several organizations have heard about Kidney Check and reached out to learn more about the model and adopt it, including a public health program called Prairie Mountain Health in Brandon, Man. and an urban version hosted by the Winnipeg Regional Health Authority’s ACCESS Centres. 

Dr. Komenda sees the need for the program to continue to be expanded upon and funded into the future. “We’ve certainly proven that we can do Kidney Check in very challenging circumstances, that it’s independently evaluated and well received, and that it brings care to vulnerable populations that really need it,” he says. “The building blocks are there.”  

Kidney Check is part of the Can-SOLVE CKD Network and is funded by a variety of regional and national partners. The Kidney Check team is looking to do as many community visits as possible with current funding and is seeking ways to sustain and build the program in the future. Visit the website to learn more.