Chronic kidney disease in Canada's First Nations: results of an effective cross-cultural collaboration.

Chronic kidney disease (CKD) is a serious and growing threat to our First Nations peoples' health. Current evidence indicates more rapid progression of CKD in First Nations populations, leading to markedly increased morbidity and mortality. To address this serious health issue, three First Nations communities, Alderville, Hiawatha and Curve Lake, partnered with the Central East Local Health Integration Network (LHIN), the Peterborough Regional Health Center (PRHC) and local family and specialist physicians. A screening tool was developed based on reported best practices to screen all community members over the age of 19 years for CKD. A unique, highly efficacious project algorithm and an electronic database were created to ensure appropriate, seamless patient care and management in this complex, multi-stakeholder environment based on client risk and CKD stage. Over the course of nine months, the project succeeded in screening 83% of all community members over the age of 19 years; 30% of clients were found to have CKD stage two or greater. A strong correlation was found between diabetes and CKD in project participants. A significant number of clients were referred for specialist care. Critical to the success of this project was the effort made to develop collaborative partnerships among five stakeholder groups: the First Nations communities, the LHIN, PRHC, local family physicians and specialist physicians.