Kidney failure is on the rise in BC, increasing by 10 % each year. Diabetes and high blood pressure are the leading causes of end-stage kidney disease, which requires regular dialysis or transplantation for survival. "End stage" refers to the end of the kidney's function, not the end of the patient's life.

Providence Health Care has the largest Renal program in BC. An integrated interdisciplinary team of caregivers-based at St. Paul's Hospital provides treatment and outreach services that include:

• kidney function clinic

• hemodialysis (in-hospital, community unit, and home-based)

• peritoneal dialysis

• pre-transplant assessment

• post-transplant care

• training, education and support

• inpatient Nephrology care

• kidney transplantation

The BC Renal Agency is also located in St. Paul's Hospital.

Dialysis is the process that performs the failed kidneys' function of filtering waste products and excess fluid from the blood. Kidneys requiring dialysis are functioning at less than 10-20% of their normal rate. Peritoneal dialysis is a simple procedure done at home, but it is not suitable for all patients. St. Paul's has 140 patients enrolled in the peritoneal dialysis program.

23% of all hemodialysis in BC is performed by the Providence renal program, more than any other health care provider. A total of 420 hemodialysis patients are currently served by a 87 dialysis stations at seven units operated under the hospital's program. Last year, the dialysis units performed 72,872 hemodialysis treatments, up from 68,674 the year before. The dialysis units, and the number of available stations at each, are:

St. Paul's	43
Vancouver Community	15
Sechelt	4
Squamish	4
North Shore	(6 open) 15
Richmond	(12 open) 15
Powell River	3
Total capacity	99 stations

Since 1986, more than 1,000 kidney transplants have been performed at St. Paul's. Of those, 580 transplant patients are currently being tracked by the Renal team. In the 2003//4 fiscal year, 76 transplants were performed.

In 2003/4 there were 76 kidney transplants at PHC, 41 of which used a donated organ from a cadaver and 35 from a living donor. Donations from living donors have significantly increased in recent years.