Kidney Living Summer 2014 by The Kidney Foundation

Living

KIDNEY Summer 2014 Volume 7 â&#x20AC;˘ Number 2

www.kidney.ca/ontario

A PUBLICATION OF THE ONTARIO BRANCH

Finding your path to reduce stress

contents LIFESTYLE 3 Managing

SUMMER 2014

Stress with Meditation:

One Patient’s Journey

4 How do you deal with stress?... 5 Caregivers 6 Caregiver Stress: It’s Real! 7 Pet Smarts 9 Psychological Effects of Kidney Transplants 10 Facing Tough Decisions About Your Kidney Care 14 Kidney Connect: Empowering kidney patients through peer support

FOOD AND NUTRITION 15 Choosing Foods at Food Banks 16 Tuna Rice Casserole THE FOUNDATION OF KIDNEY CARE 13 Walk for SomeONE You Love at Kidney Walk 17 Gala Chair Grateful for Advances in Kidney Research 21 Community Highlights 23 Mark This Date RESEARCH AND MEDICAL CARE 18 Making a Mark in Transplant History 19 Investing in Research

*In an effort to optimize our space in these pages and still bring you good, quality information that you can use, these articles are part of longer articles. Read the full story at www.kidney.ca/kidneyliving. Cover photo: Bobbie-Lynn Burton includes a variety of activities in her day to maintain an active lifestyle. Canadian Publications Mail Agreement #40011479 Return Undeliverable Canadian Addresses t o Tr i s h R e y n o l d s , C o m m u n i c a t i o n s Manager, Circulation Department, 1599 Hurontario St., Suite 201, Mississauga, ON L5G 4S1; email:communications@kidney.on.ca. Phone:1-800-387-4474.

©2014. Kidney Living, the contents of which is subject to copyright, is published twice a year. Reproduction in whole or in part, in written, electronic or any other format, without prior written permission, is strictly prohibited. For more information, contact Trish Reynolds, Editor at treynolds@kidney.on.ca or 1-800-387-4474 Ext. 4981.

The appearance of advertising in Kidney Living does not imply an endorsement by The Kidney Foundation of Canada, nor guarantee the quality, effectiveness of any products or services.

Editing, design and printing by GEPM Group Inc. www.gepmgroup.com

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LIFESTYLE

Managing Stress with Meditation: One Patient’s Journey

by Erin Rayner

Just try! Any little bit helps.

Words of Wisdom from Bobbie-Lynn: • You just have to do it, listen to your body but you just have to do it. • Don’t do what others are doing and only do what your body can do. • Don’t push your limits. • Do whatever you can; if that means only five minutes then do it. Five minutes is better than nothing at all. • Just try! Any little bit helps. www.kidney.ca/ontario

Bobbie-Lynn doing her meditation pose

tress is a normal part of life for everyone and is usually balanced by a healthy lifestyle and having a good support system. Now imagine your everyday stressors, whether they are work related or issues in your personal life, and how you would balance those stressors on top of having a chronic disease such as kidney disease. It is difficult to imagine if you are not living in that situation. Meditation is one technique that is used to deal with stress. To meditate is to “think deeply or focus one’s mind for a period of time, in silence or with the aid of chanting, for religious or spiritual purposes or as a method of relaxation.”1 Take a deep breath as I begin the story of Bobbie-Lynn, an incredible woman who has been battling kidney disease for most of her life, and how she deals with stress. At the age of four, Bobbie-Lynn was diagnosed with a condition called urinary reflux. The valve that prevents urine from reentering the kidneys does not work and each time the bladder is emptied, urine flows back up the ureter to the kidneys2. This caused her kidneys to function at only 30 percent. When Bobbie-Lynn turned 23, her kidneys failed and forced her to start hemodialysis. She now participates in a nocturnal dialysis program three times a week in hospital, and tries to sleep through her overnight treatments. In 2012, Bobbie-Lynn lost her fistula access, the point at which the blood enters and exits the body to be cleaned by the dialysis machine. After the doctor’s reassessment for another long-term access, they discovered blood clots. This caused a huge increase in Bobbie-Lynn’s stress level and her search for a living kidney donor began. However, with an elevated antibody level and blood clots, 10 people were tested and no match found. Although this was a major setback in Bobbie-Lynn’s life, she Summer 2014 / Kidney Living /

LIFESTYLE

continued working full time and going for dialysis treatments and never stopped living an active lifestyle. She enjoys long walks, bike rides, and makes a point of taking the stairs at the hospital instead of the elevator. In addition to all of this, Bobbie-Lynn now participates in a stress reduction workshop to help decrease and manage the stresses in her life. “Mindful” stress reduction is a six-week workshop which encourages the participant to practice for one hour a day with the support of a workbook. It consists of relaxation exercises, meditation and breathing exercises. Although Bobbie-Lynn tried meditation in the past to fall asleep and found it was not helpful, the opportunity arose to try it through her work. “No harm in trying,” she thought. “If it works it works, and if it doesn’t, it doesn’t.” Now three weeks in, Bobbie-Lynn does a three-minute check in, paying attention to how her body feels, complemented by a five-minute breathing exercise to calm her down and make time for herself before bed. She is also incorporating 15-minute meditation sessions while on dialysis with hopes to increase it to 45 minutes. She has already noticed a big difference. Some days it still feels as though a huge weight is carried on her shoulders and she still sometimes struggles to try and live a normal life, but stress reduction has rewarded Bobbie-Lynn in many ways. The benefits she has experienced are stress reduction and feeling more relaxed. She is better able to accept her condition. She has even seen a decrease in her blood pressure, and has now adopted a new way to enjoy life. Having chronic kidney disease has been a lifelong battle for Bobbie-Lynn and maintaining a low stress life can be difficult, but is crucial to keeping a healthy, long life. We all live busy lives and can easily forget to make time for ourselves and stop worrying about our health issues, but with a little help and guidance, anyone can do it. You can follow Bobbie-Lynn on her blog at www.bobbieskidney.com. Editor’s note: We are pleased to report that Bobbie-Lynn received a kidney transplant in June and continues to meditate daily. www.google.ca/?gws_rd=ssl#q=definition+of+m editating 2 http://www.renalresource.com/brochures/ur.php 

How do you deal with stress?...

We asked our kidney community to share their tips and tricks for dealing with stress in their lives. take my meds and live as normal a life as is possible. I fish, I work part time, we go out with friends. Every year I walk the Kidney Walk, and remind people every day to sign up to be a donor. Shawny Mac (Kidney Connect user) I basically try to practice the Serenity Prayer. I do the best I can, don’t beat myself up if I make a mistake (forget my pills or “indulge” in particular drinks, or salt, or meals), and try to roll with the punches when stuff happens. I didn’t do well on dialysis, but I look back, sigh heavily, and realize that I could do it again if I had to if/when my transplant fails. As I said, rather than quoting, or reciting, I try to put things into practice. I do volunteer work. I try to be productive. I do the best I can every day (some days not altogether successful, but at least I try). And I realize that this is an acquired skill. You learn from every setback, every stressful event. What’s important is that you try to learn from the stressors. Evaluate a bit and decide if there was actually something that you could have done, be it talk to a doctor better/differently/ sooner, or simply to breathe deeply and try to stay calm. Sometimes simply sitting back and reminding yourself that “this too, shall pass” is the only thing you can do. And you learn to accept that. Mrs. Cora (Kidney Connect user) Take control of what you can, let go of what you can’t; learn to know the difference. Nancy, Ottawa Personally, I manage stress by slowing down my brain because if I get too far ahead of myself with so many items to do I feel overwhelmed. I try my best to live in the now, stay present, and breathe! It’s hard to stay present, I think because our minds have a way of running away to things that happened a long time ago or alternatively thinking of things that have not yet happened. I also try to get breaks throughout the day with co-workers to have a laugh, or at home take a break to get out into nature, go for a walk, listen to music. Marisa, Halton 

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Photo credit: GraphicStock.com/beach_2008001389-1113int-beach

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LIFESTYLE

Caregivers It’s Also Important to Care for Your Own Needs

by Heidi Westfield

amily caregivers are a central support to people living with kidney disease, especially those on home dialysis. They help with the patient’s day-to-day medical needs, and see first-hand the emotional ups and downs of being a kidney patient. Taking on that role though, can be very taxing, both physically and mentally. Caregivers may see their independence disappear as they put the needs and interests of a sick loved one ahead of their own. Fatema Begum describes her life in Toronto, before her husband was diagnosed with kidney disease, as one with “lots of happiness.” They had moved to Canada from Bangladesh; she was working at a drug store in Toronto, and her husband was also employed. Fatema loved children and, bolstered by a Masters Degree in Home Economics, had plans to work in education. Those plans began to unravel when doctors diagnosed her husband with severe kidney damage in 2007. Suddenly, the new life they were building for themselves was dramatically altered. Fatema felt they were in this together; she left her job to care for her husband. She learned about peritoneal dialysis from a training course at St. Joseph’s Hospital. Soon she was learning how to set up the dialysis equipment at home, administering needles and changing the dressings. The first months were hard, and she felt depressed. Being a caregiver was more demanding in many ways than a job outside the home; she was on duty every day, 24/7. There were fun times, but it could get monotonous, and emotionally challenging. There were so many questions that lingered uneasily in her mind: “How is he feeling? What is going to happen? How will we cope?” She has found over the years that carving out time away from her caregiving role makes all the difference. “It is not easy to get some time for myself, but I need it very badly.” Her husband’s health has improved, and now Fatema volunteers in the community, and has found a parttime job in an elementary school. It’s an opportunity to spend time with children—something she has long wanted to do. “My co-workers and my students make me happy,” she says. “I can say it works like medicine.” With her husband now close to the top of the list for a transplant, their lives are moving forward with renewed hope. Her advice to other caregivers out there? Try to be as patient as possible with the mood swings and fatigue that can accompany renal disease. Learn as much as you can about your partner’s condition, and find a way to care for your own needs as well.  www.kidney.ca/ontario

Fatema Begum and her husband, GM Lehaz Uddin

There were so many questions…

Summer 2014 / Kidney Living /

LIFESTYLE

Caregiver Stress: It’s Real!

caregiver is a spouse, partner, daughter, son, sibling, parent, other relative or friend—anyone who provides help or care to someone with a long-term health condition, a physical or mental disability, or someone with problems related to aging.

• Anger • Feeling unhappy, sad, and/or depressed (please see The Kidney Foundation of Canada fact sheet Dealing with Depression for more information) • Feeling alone • Loss or increase of appetite

DID YOU KNOW?

WAYS TO MANAGE CAREGIVER STRES

• Nearly 3 in 10 people are family caregivers • In 2012, about 8.1 million Canadians were providing caregiver services

• Connect with others. Feel free to speak with the renal social workers at the hospital to ask about resources available. The Kidney Foundation also offers free peer support for people whose lives have been touched by kidney disease. Call 1-866-3907337. • Ask for help and accept it. • Try to laugh; it really is the best medicine. • Take some time for YOU. Go for a walk, read a book, take some yoga classes, go fishing; whatever makes you happy. Make some time and go do it. • Realize that no one is perfect. It is normal to feel guilty, like you are not doing enough, or feel frustrated; this is okay, you can only do what you can do. 

Caring for a friend or family member can add additional tasks and responsibilities which can be a major source of stress. Here are a few signs you may be under increased stress: • Difficulty falling asleep • Difficulty waking up • Feeling tired more often than not (exhaustion) • Anxiety around your caregiving responsibilities. This can feel like muscle tension, headaches, chest pain, stomach problems, tingling sensations, concentration and memory problems

Photo credit: BigStock.com/24605600

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LIFESTYLE

Pet Smarts

What to do about Rover?

ur programs team fields a lot of questions about pets and home dialysis care. We posed some of your questions to renal professionals to learn best practices for handling pets and keeping yourself as healthy as possible. While your loving four-legged companion helps reduce stress, it’s important to take the necessary precautions to ensure that the environment where you do your home dialysis is a safe, clean environment. Q: Can I keep my dog or cat now that I am on peritoneal dialysis? A: Yes, you do not need to get rid of your dog or cat while on PD.

Q: Can I still clean my cat’s litter box or pick up after my dog? A: Yes, just remember to thoroughly wash your hands afterwards. Q: Why must my pet be kept out of the room while I do my manual exchange? A: Cases of peritonitis have been documented in the past which link the presence of pets in the room to the infection. Peritonitis is an infection of the peritoneal cavity, and is very painful and can lead to cloudy effluent. If you suspect a case of peritonitis, see your nephrologist immediately to ensure continued function of the peritoneal membrane. Q: Can my pet still sleep in the same room as me during the night while I use my cycler? A: No, pets must stay out of the room where your peritoneal dialysis takes place. There are concerns with pet dander, and dogs chewing tubes, wires or cords. Cats in the bedroom pose a real and potential problem, puncturing the solution bag, lying on the “warm” heater bag on the cycler machine and “kneading” with their claws, again puncturing bags. Chewing into drain lines has been known to happen as well. Q: What are some easy rules for me to follow while living with my pet and doing PD? A: The room or vicinity where you do your dialysis, whether you do manual exchanges or use a cycler, should be pet free at all times; you must wear a mask and hand wash for your exchanges; good hand washing in general; close all windows; turn off all fans. 

Photo credit: GraphicStock.com/6996-101413-gs-6996

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Summer 2014 / Kidney Living /

LIFESTYLE

Psychological Effects of Kidney Transplants

rgan transplants are by far among medicine’s most technologically advanced procedures with the potential to change the quality of life of patients and families affected by kidney disease. In 2012, 600 people in Ontario received a kidney transplant, while another 1,000 were awaiting one.* Each step in the transplant process involves its own challenges. Initially, there’s the shock that comes with receiving the diagnosis of endstage kidney failure which will require dialysis and/or a transplant. Patients may experience fear and anxiety about whether they will meet the medical criteria to be a potential recipient. Once on the organ waiting list, patients may experience a range of emotions, which could include the following: • fear that no compatible organ will become available • growing awareness of the severity of their illness and their own mortality • decreased ability to function in all areas of life • alienation from their social circles • tension with spouse and family as a result of uncertainty • increasing sense of discouragement and hopelessness as the wait drags on. During the waiting phase, patients may also experience feelings of guilt, often because they may feel they are competing with others waiting for a kidney transplant, or because by hoping to receive an organ, they are indirectly hoping a potential donor will die. As the surgery approaches, fears may become more specific—the procedure, anaesthesia, hospitalization and the odds of success. During the period immediately following the transplant, recipients may experience relief and hope, which often reduces anxiety; however, for some, anxiety returns quickly as the first biopsies are conducted to assess the state of the transplanted organ. Over the longer term, the acknowledgment of this “second chance at life” leads to growing awareness of the need for treatment adher-

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ence, risks of various complications (episodes of rejection, readmission to hospital, side effects from medication), lifestyle changes that need to be made, and challenges of reintegrating into society. As a result, it is perfectly normal for people to experience some degree of psychological distress during the transplantation process. Remember that members of your healthcare team are available to discuss your concerns and feelings with you. Reaching out to someone through The Kidney Connect Peer Support Program may be helpful. Kidney Connect is available by telephone at 1-866-390-7337 or peer networks can be found through The Kidney Foundation of Canada online support network www.kidneyconnect.ca. Post-transplant psychiatric complications

In the month following the transplant, recipients can obtain psychological support from psychologists who specialize in organ transplantation, social workers or other trained members of the medical team. The mixed and poorly understood emotions that follow the transplant, such as feelings of indebtedness, guilt, and being indebted to the donor, are completely normal. “It is important to understand that transplants are not a cure; however, they are the only alternative to dialysis, and they can involve a difficult adjustment,” says Dr. Marie-Josée Hébert, researcher at the CHUM Research Centre (CRCHUM) and Director of the Organ Transplant Program at Université de Montréal. “Many patients, especially young ones, expect their transplant to be a cure that will restore the life they once led. This, despite doctors’ insistence on both the importance of preparation and the fact that the transplant will not be a long and smooth road. But for patients awaiting a transplant, these words often fall on deaf ears. We have also noted that many patients have a blasé attitude toward kidney transplantation because transplants are now so widely available in our society. As a result, potential organ recipients rarely consider the negative effects they may www.kidney.ca/ontario

LIFESTYLE

experience and often feel depressed in the six months that follow the transplant, especially young patients and those on peritoneal dialysis.” The psychological consequences of kidney transplantation may include:

• Positive outcomes, such as feelings of accomplishment, ability to maintain a sense of self in the future, the quality of the social support system and a sense of independence. • An episode of depression in those who idealize the transplant. Often people mourn their unrealized dreams, such as that of regaining full health after the transplant. They also feel guilty for not being able to contribute to society. This is a feeling patients often have trouble expressing. • Difficulty accepting the transplanted organ as a natural part of themselves, seeing it instead as a foreign body. This idea of its foreign nature is reinforced by the need to take anti-rejection medication and have blood levels checked. • Anxiety about the potential rejection of the transplanted organ and the possible return to dialysis. • Potential mood disorders linked to the transition from dialysis patient to transplant recipient. Some patients mourn their former life and the relationships they developed at the hospital. In the case of deceased-donor kidneys, transplant recipients may also mourn the donor.

Quot es, Not es Anecdot es

Then and Now. When The Kidney Foundation was first founded in the 1960s, dialysis was a treatment not available to everyone. Today there are so many more choices available and patients can choose the dialysis therapy fit that best suits their lifestyle. In the early days, hemodialysis or ambulatory peritoneal dialysis (APD) were the only two choices. Now there are options for patients to dialyze at home on either hemodialysis or peritoneal dialysis, in the hospital renal unit, or satellite locations closer to home.

For decades, the line between mental health and physical health has been blurred. Psychologists have long been aware of the impact that physical health problems can have on mental health, and vice-versa, and have become a part of the kidney care team that is available to assist patients in coping with dialysis, transplant and/ or the recovery process. Sources: La psychologie de la santé, les enjeux psychologiques de la greffe d’organe. Achille, Marie, professor and researcher in the Psychology Department at Université de Montréal. Psychologie Québec, January 2002. With Dr. Marie-Josée Hébert, researcher at the CHUM Research Centre (CRCHUM) and Director of the Organ Transplant Program at Université de Montréal. Reprinted with permission of The Kidney Foundation’s Quebec Branch; originally published in Your Health, Spring 2013. *Trillium Gift of Life Network, 2013 Statistics.  www.kidney.ca/ontario

Upper left: Hemodialysis machines used today. Above: Machines from the 1950s looked much like a large stock pot. Photos taken by Rizwana Ramzanali. Summer 2014 / Kidney Living /

LIFESTYLE

Facing Tough Decisions About Your Kidney Care What Can Help?

by Mary Ann Murray RN PhD, Janice Bissonnette RN PhD and Janet Graham RN MScN

oan’s kidneys are not working very well. She knows that when her kidneys are working at less than 10 percent she will likely need dialysis or a kidney transplant. This will be a big change in Joan’s life. She is worried about her family, what will happen to her work and how she will feel. She knows she needs to make some decisions. Joan isn’t sure what kind of dialysis is best for her. It is important for Joan to decide what her best treatment option is early, as preparation is required for each of the choices. If her kidney disease progresses more quickly than expected it could mean that she may have to make a decision quickly. Delaying the decision could mean that she may have to start a type of dialysis that would not be her first choice and wouldn’t fit well with her lifestyle. By thinking about her options ahead of time Joan can put the pieces together and take steps that will improve her health, quality of life and independence. Early preparation can lower the chance of getting sick and needing hospitalization. Joan and her kidney care team plan to talk about making a decision at her next clinic visit. Joan is feeling anxious and unsure. In this article, we discuss ways to help people like Joan to be better prepared for making choices about their care and preferences for treatment.

Tips for reducing decisional conflict Not sure about the • Make a list of your questions facts… • Ask as many questions as you need to really understand your treatment options • If you need more information follow up with your nephrologist and health care team Not sure about what • Talk to others is most important to • List the pros and cons of each option you… • Rate the pros and cons of each option on how important they are to you • Complete the Ottawa Decision Guide; available at http://decisionaid.ohri.ca/decguide.html Feeling not enough • Discuss your needs with a trusted person (e.g. nephrologist, nurse, social worker, counsellor, support… family, friends) • Find out what help is available to support you (e.g., funds, home help, community agencies) Feeling pressure from • Focus on opinions of others who matter most to you others… • Find a neutral person to help you and others involved

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www.kidney.ca/ontario

LIFESTYLE What is Shared Decision Making?

You know more about your body, your health, and what’s important to you than anyone else. Your healthcare team knows about the latest treatments and options that could benefit you. In shared decision making, patients and practitioners (i.e., physicians, nurses, social workers) decide together on a best option. Patients bring information about what is most important and practical for them. Practitioners provide information about the likely reasonable options, benefits, and risks. The goal is to make a decision that is based on knowing the most up-to-date scientific evidence and what is in sync with the patient’s views about what is most important for them. For some decisions, it is quite easy for patients and practitioners to reach a decision. However, for many kidney care decisions, there is no clear “right” or “wrong” choice. Signs of Decisional Conflict

• Feeling unsure about which option to choose • Concern about ‘bad’ outcomes • Waver between two options • Delay making a decision • Questioning values • Feeling preoccupied with the decision, distressed, and/or tense Why Are Many Kidney Care Decisions Difficult?

Several options are often available for treating or managing end-stage kidney disease. Each has different benefits and risks. Patients facing these “tough” decisions may feel uncertain about which option to choose or what next

Photo credit: BigStock.com/13912418

Making Kidney Care Choices What to do…

What to ask about…

• Write down your needs, wants, interests, what is most important to you and what you would most want to avoid • Compare the pros and cons of options to your list of needs, wants and interests • Ask others about their experiences • Plan ahead. Get information about options for different kinds of care before you need it and discuss with relatives or those close to you • Ask for numerical information, such as the chances of experiencing a particular outcome, to be given in real numbers rather than percentages (i.e., 10/100 rather than 10 percent) • Ask that the pros and cons of each option be explained in both positive and negative terms (i.e., 2/100 people will likely experience this side effect and 98/100 will not experience this side effect)

• Types of decisions you expect to face in the next six months • What options are available • How soon does the decision need to be made without compromising your health or circumstances • Costs (what’s covered by OHIP or other insurance) • How will the different options affect your quality of life • What is the increased risk of experiencing a particular outcome or event over your baseline risk of experiencing that outcome without the treatment

www.kidney.ca/ontario

Summer 2014 / Kidney Living /

LIFESTYLE

steps to take. This uncertainty is called decisional conflict. Decisional conflict can be caused by not having enough facts or knowledge; being unsure about what to expect; feeling unclear about what is most important to avoid or achieve from the possible consequences; not having enough advice or resources to make the decision; and/or feeling pressured by others to make a decision. Decisions about newer treatments are often difficult because often there is limited or conflicting scientific evidence about their effects. Are there tools to help make decisionmaking easier?

Decision support tools can help patients and their care team figure out individual decisionmaking needs. Decision support tools complement discussions between patients and their practitioners. They do not replace these discussions. Option grids and patient decision aids are two types of decision support tools. At the Ottawa Hospital Nephrology Jindal Kidney Care Centre, a group led by three Advanced Practice Nurses developed an Option Grid called, Comparing treatment options for when your kidneys are not working. Answers to frequently asked questions about the usual options (kidney transplant, dialysis at home or in a facility, and supportive care) are provided in a table. Patients who have used this tool have found it very informative and helpful. The team has also developed a patient decision aid for, “When you need to think about dialysis option,

Quot es, Not es Anecdot es

Dr. Edward H. Cole

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should you receive your dialysis at home or in a facility?” Patients in the Progressive Renal Insufficiency Clinic have told us that using the decision aid helped them feel more prepared to identify a treatment option. They also said that using the tool made the decision easier to make and helped them plan their next steps. Are there other resources to help make decision-making easier?

There are many tools designed to help you make the decision best for you. Visit our website www. kidney.ca/kidneyliving for a comprehensive list of tips and links to additional content about decision making resources. Surveys show that Canadians want to be involved in decisions about their health. However, people like Joan can feel overwhelmed and uncomfortable making decisions about their care. Not having enough information, being uncertain about what to expect, feeling unclear about what is most important and feeling pressured or unsupported can make decisionmaking more difficult. By being part of shared decision making with your health care team you can make sure that you make the decision that is right for you. Studies have shown that patients who have had experience in participating in their care decisions find it easier when facing a new set of decisions. Ask questions to understand your treatment options and share with your healthcare team what is important for you so that you receive the best possible care in a way that best fits for you. 

Mary Ann Murray RN MScN PhD is the Advanced Practice Nurse for the Home Dialysis Program at the Ottawa Hospital. Janice Bissonnette RN-NP MScN PhD is the Advanced Practice Nurse for the Nephrology Clinics and Renal Transplant Program Janet Graham RN MScN is an Advanced Practice Nurse, Vascular Access Coordinator

“When I trained in Nephrology in 1977-78, the one-year success rate for kidney transplants was 50 percent. The frequency of acute rejection was very high and most patients had severe side effects from high dose Prednisone. I have been fortunate to have been part of the gradual improvement in outcome which, in substantial part, is a Canadian success story. This started with the introduction of cyclosporine A, stemming from a multi-centre Canadian randomized trial, led by Dr. Cal Stiller from London. But even in the 30 or so years since then, with the advent of other new drugs, better general medical care and matching, and prevention and treatment of infections, we have seen one-year success rates above 90 percent with the majority of patients on low dose steroids, if any, and acute rejection rates of only 10-15 percent. This success has been the most satisfying for me.” Edward H. Cole MSc MD FRCP(C) Physician in Chief, University Health Network Dr. Charles H. Hollenberg Chair in Medicine at University Health Network, Professor of Medicine, University of Toronto  www.kidney.ca/ontario

THE FOUNDATION OF KIDNEY CARE

Walk for SomeONE You Love at Kidney Walk

This Fall, Walk For SomeONE You Love www.kidneywalk.ca

e all walk different paths, but this September while we walk in different places, on different days, we will join as a kidney community to take steps and inspire hope for a future without kidney failure at the Kidney Walk. Dialysis patients will walk beside transplant recipients, family members and friends will walk in honour of someONE they love, renal professionals will show their support by walking alongside their patients, all in an effort to raise funds to support kidney research, programs and services that help those living with the disease. Please take the first step today and register your team for the Kidney Walk in your community. We need your help to reach our goal of $850,000.

My dad

is ONE

I am ONE

I remember our first Kidney Walk. It was just two short weeks after I was diagnosed with kidney disease, and it gave me such hope during such a difficult time. Our second walk in 2013 felt more like a celebration for little Lucas. There are still many challenges and it’s hard to leave Lucas to go for dialysis but I’m lucky to have the support of my family, friends and The Kidney Foundation. I walk for a future without kidney disease. Heather St. Pierre, Belle River

I am O

I care for ONE

I care

for O

Aiden is ONE

I walk because my son Aiden is ONE. Aiden was born with small dysplastic kidneys. For him, kidney disease meant spending the first month of his life in the hospital. It means that he is unable to eat, having to get all of his nutrition from a feeding tube. It means that now, at two-andhalf-years old, Aiden has spent more than a third of his short life attached to a dialysis machine. Aiden’s father Bryan and I had hopes for a transplant, but unfortunately no member of the family was a match. Now we are looking for a donor match through Living Donor Paired Exchange, and are hoping Aiden will receive a new kidney soon. However, receiving a kidney transplant is only a treatment, not a cure. Kidney disease is something Aiden will live with for the rest of his life. Melanie Ego, Orillia My dad is ONE

My dad, Bob, started dialysis a week after my mom died in 2006. He goes for treatment three www.kidney.ca/ontario

times a week; he is well cared for and comfortable during treatment. The Kidney Foundation has added to his comfort level by providing blankets and bags and friendly visitors. Without treatment, my father would not be with us. We would have lost another treasure. I walk to raise money for The Kidney Foundation to help fund scientific research to help ease the burden of those suffering with kidney disease and those who love them. I walk for my dad. Judy Hubbard, Sarnia

I participate in the Walk to show my support to renal patients and my friends living with kidney disease.” Sam Watt, Renal Social Worker, Scarborough My daughter is ONE.

My da

ughter

is ONE

I am O

Five years ago my daughter was like any other teenager starting university. A routine blood test showed that her kidneys were failing and within a few short months she started dialysis. Her co-worker was tested to see if she would be a suitable donor for a kidney transplant. Although she was a match there were complications during the surgery and the kidney was lost. Back on dialysis and regaining her strength, a neighbour stepped forward and volunteered to be tested to be a donor. He was a match! This time everything went perfectly and she is now healthy and strong, experiencing life to the fullest. A transplant is not a cure though, and we know that a donated kidney usually lasts 15-20 years. This may sound like a long time unless you are 23 years old with a whole life to live. Once again this year I will be taking steps and inspiring hope to help raise money for The Kidney Foundation. Kathi Elliotson, St. Catharines  Summer 2014 / Kidney Living /

WORKING TOGETHER

Kidney Connect: Empowering kidney patients through peer support by Trish Reynolds

onnecting with someone who has a shared experience can be one of the best ways to reduce stress, gather information and validate one’s feelings. Sometimes hearing from a peer that they managed the lifestyle changes often required after diagnosis or a change in treatment modality can be just the reassuring voice needed during a stressful time. For over 20 years, volunteer mentors have been sharing their experience to help others living with kidney disease, including those diagnosed, family members, caregivers and living organ donors. Support is offered primarily over the telephone and, when possible, in person. Kidney Connect is staffed by a team of volunteers who’ve been specially trained as mentors. These volunteers are all either living with the disease themselves or have been affected by it in some way. They understand how difficult it can be, and can offer the personal encouragement and support needed. Peter, from Oshawa, connected with a volunteer when he first learned that he had kidney disease. “My connection with my peer support volunteer was wonderful. Speaking with him gave me such a good and balanced reality to facing the challenges that I knew were ahead of me. I never expected this to happen to me so when it did, I had to face things I really didn’t want to think about and it was hard. So much depends on attitude, and my volunteer really helped me with that.”

Connect with others... KidneyConnect.ca is a new online social network for people living with - and affected by - kidney disease

Join today to enjoy these great features: Discussion Forums • Blogs • Events Support Groups • Photos • Chat • Video

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In addition, peer support groups operate in several communities in Ontario. Peer support volunteers facilitate the groups, with the support of local hospital renal programs and The Kidney Foundation. Organizers say that for those struggling with the disease’s impact on their lives, meeting and talking with other patients offers a reassuring camaraderie. “Peer Support meetings make me smile. Knowing the problems and situations of new and old participants may be different or similar to mine, and discussing them helps us all cope and understand our disease better,” said Bob from Thunder Bay. Joyce also attends the peer support meetings in Thunder Bay and encourages others to come out and give the meetings a try. “Never be afraid to try something new. This group experience turned out to be a perfect match for me and my life with kidney disease,” Joyce added. In 2013, Kidney Connect expanded once again and began offering support through an online social network. KidneyConnect.ca is The Kidney Foundation’s most recent effort to respond to the growing and changing needs of the kidney community. KidneyConnect.ca moderator Hilary is a valued Kidney Connect volunteer. She has volunteered with the program and connected with fellow patients by phone, and is now using her experience to foster conversation online. “My experience with KidneyConnect.ca has been amazing! We are growing daily, which really contributes to the supportive atmosphere of our social network. A few keystrokes, at your leisure, in the comfort of your own home, and you are able to connect with hundreds of others who ‘get it,’ who share the same triumphs and struggles of living with kidney disease,” said Hilary. “It’s important for people accessing peer support, to do it in the way that best suits their needs and preferences,” said Anne Brinkman, Ontario’s Peer Support Manager. “For some, reaching out online through the new Kidney Connect.ca meets their needs, but for others, being able to reach out by phone or in a group setting is what feels best. Through Kidney Connect, we want to empower patients and family members accessing the program to reach out for the support needed in whatever way feels most comfortable to them.” www.kidney.ca/ontario

FOOD AND NUTRITION

Quot es, Not es Anecdot es

“The establishment of The Kidney Foundation in 1964 became a beacon of hope for families like mine who watched helplessly as loved ones succumbed to kidney failure in an era when dialysis was more theoretical than actual and transplantation only worked between identical twins. Over the years the Foundation became a passionate and successful advocate for research and access to dialysis and transplantation. In particular, The Kidney Foundation in Ontario played a leadership role in the establishment of the Trillium Gift of Life Network in 2002 and the Ontario Renal Network in 2009. I am proud to have been able to contribute to this important work along with so many others and wish the Foundation 50 more years of success.” Janet Bick Retired Director, Programs & Public Policy  www.kidney.ca/ontario

Choosing Foods at Food Banks

by Pamela Sleightholm, Mississauga Food Bank

tarting out on a renal diet is a challenge. There’s a lot to learn, hidden ingredients to look out for and often, a pretty big lifestyle change. If money has become tight, you may be considering going to a food bank for assistance. But will donated food fit into the renal diet? Getting a few staples from the food bank to supplement your groceries can help free up some money to buy items that are more difficult to come by through donations. Keep in mind that there are different types of food banks across the province. In rural areas, you may be limited to food pantries that provide non-perishable food only. In cities, you could have access to a full-service food bank that offers fresh dairy, bread, fruits and vegetables, as well as frozen products. Some food banks in Ontario will distribute food to a family every week, others once a month. Some common food bank items that fit into the renal diet are white rice, white pasta and rice or corn cereals. Peanut butter, dried beans and canned fish are protein-rich foods that are often available. Volunteers and staff at the food bank will try to accommodate dietary restrictions—be sure to take time to let them know what kind of food you’re looking for on your first visit. “We always try our best to get people the healthy food they need,” says Dawn Pullar, director of agency relations at The Mississauga Food Bank. “Food bank staff and volunteers understand that there are some clients who come to us with restricted diets. We’ll do what we can to get them appropriate food.” Canned foods are staples at food banks—but since many canned foods are high in sodium or potassium, you may need to get creative when it comes to preparing meals that will fit into the renal diet. Seek out canned items that have no added salt or sugar and give canned vegetables a good rinse before using them. At many food banks, you’ll be given a pre-loaded cart of food to choose from. Bring your own bags and pick through to find the items you want, but don’t hesitate to leave what you don’t want behind. Don’t feel obligated to take home a box of salty crackers or any other food that won’t help improve your health. To find a food bank in your area, visit www.oafb.ca.  Summer 2014 / Kidney Living /

Photo credit: GraphicStock.com/145-1013-P0145

Peer support is an effective way to help kidney patients adjust to dialysis, and the variety of dialysis modalities currently available; it can aid in alleviating fears about kidney transplantation and even serve as an example of how to talk to friends and family about the disease, or serve as a positive example of how someone lives well with a chronic illness. “The uniqueness of being able to connect with so many people, to exchange ideas and experiences is something that is not lost on me. Having personally been on hemo dialysis since 2004, I realize how isolating chronic illness can be. This KidneyConnect.ca online forum offers a tremendous sense of community,” added Hilary. 

FOOD AND NUTRITION

Tuna Rice Casserole Renal Diet Nutrient Analysis Servings per recipe: 6 Serving size: 1/6

Nutrient Analysis Calories: 348 Protein: 17g Carbohydrates: 28g Fibre: 1g Total Fat: 18.4g Sodium: 203mg Phosphorus: 272mg Potassium: 293mg

Renal and Diabetic Exchanges 2 protein 1 dairy 1 starch

f low sodium tuna is unavailable, use regular tuna, drain well and rinse with water in a sieve for 1 minute. Freeze leftover casserole in individual portion sizes and use at a time when you have no time or energy to prepare a meal. Source: Seasonal Cooking for Renal Patients, reprinted with permission from the University of Alberta Hospital

Diet Type: Low Phosphorus / Low Potassium

Ingredients

6 ½ oz (195 g) tuna, low sodium 3 cups (750 mL) white rice, cooked 1 cup (250 mL) cheddar cheese 3 oz (90 g) cream cheese 1 cup (250 mL) sour cream ½ cup (125 mL) onion, chopped 1/8 tsp (½ mL) garlic powder ½ tsp(2 mL) basil 1 tomato, sliced 6 ½ oz (195 g) tuna, low sodium 3 cups (750 mL) white rice, cooked 1 cup (250 mL) cheddar cheese 3 oz (90 g) cream cheese 1 cup (250 mL) sour cream ½ cup (125 mL) onion, chopped 1/8 tsp (½ mL) garlic powder ½ tsp(2 mL) basil 1 tomato, sliced

Directions

1. Combine tuna, rice and cheddar cheese. 2. Spoon the mixture into a shallow, greased baking dish. 3. Beat cream cheese until smooth. 4. Stir in sour cream, onion, garlic powder and basil; spoon over tuna mixture. 5. Cover dish with foil. 6. Bake at 350°F (180°C) for 30 minutes. 7. Uncover and top with tomato slices. 8. Return to oven for 5 minutes and serve.

www.kidneycommunitykitchen.ca 16 / Kidney Living / Summer 2014

Renal Diet Nutrient Analysis Servings per recipe: 6 Serving size: 1/6 www.kidney.ca/ontario

THE FOUNDATION OF KIDNEY CARE

Gala Chair Grateful for Advances in Kidney Research his 50 th Anniversary of The Kidney Foundation has great personal significance for me and my family. Both my father and grandfather died just short of their 50 th birthdays of causes related to Polycystic Kidney Disease (PKD). In those days (’70s and ’50s, respectively) treatment and prevention methods were primitive compared to the medical miracles of today. This year, my sister Dobbie, who is coincidentally 50 years old, underwent a successful kidney transplant. Her donor

www.kidney.ca/ontario

was her husband, Steve. We are very grateful to the kidney research and transplant community for their hard work in ensuring that people afflicted with kidney disease can live longer and productive lives. I am very proud of the important contribution that The Kidney Foundation makes through the efforts and generosity of so many dedicated staff and volunteers. Happy Anniversary, Kidney Foundation! Dean Newman Chair, The Golden Gala 

Summer 2014 / Kidney Living /

MEDICAL RESEARCH

Making a Mark in Transplant History Reprinted from The Kidney Foundation’s 50th Anniversary Magazine 50 Kidney Stories. Read more inspirational stories at www.kidney. ca/50stories.

r. Calvin Stiller, a native of Saskatchewan, made an indelible mark in transplantation history by coordinating the Cyclosporine Study out of London, Ontario in the 1970s. It was the first multicentre clinical trial in kidney transplantation in North America, involving 21 of the 22 centres in Canada. This trial created the foundation for future studies that put Canada on the world stage in transplantation. Today, cyclosporine remains one of the drugs of choice to combat tissue rejection after transplantation. Swiss researcher, Dr. Jean-Francois Borel, first examined cyclosporine, a drug derived from a fungus found in the Norwegian fiords, while working for the pharmaceutical company Sandoz. He noted that cyclosporine was able to inhibit T-cells [cells that fight infection in the body], but because it didn’t have the antibiotic properties that Sandoz was looking for, Dr. Borel was asked to discontinue his research on this molecule. It was a directive he did not follow. Instead, Dr. Borel gave Dr. Stiller a vial of the drug after a chance meeting at a conference in Rome in 1978. Dr. Stiller’s team became one of the first in North America, and the first in Canada, to use it successfully on humans. From that moment, the transplant landscape completely changed. “Before cyclosporine, we lost 50 percent of all kidney transplant patients, many dying with functioning kidneys,” he says. “After the introduction of cyclosporine, it was like night and day.”

Kidney Patients Can Still Have Their Dreams Come True

In addition to his ground-breaking work as a researcher, Dr. Cal Stiller is a successful serial entrepreneur and an optimist when it comes to the promise of research for kidney patients. “I would say to people on dialysis, or who have received a kidney transplant and have limitations coming from that, that they can still have their dreams come true. Based on my experience with kidney patients, I think people

18 / Kidney Living / Summer 2014

with disabilities can accomplish things in ways that people without disabilities, frankly, never achieve.” He believes kidney patients learn how to bring powerful latent abilities to the forefront—abilities they may never have developed otherwise. Dr. Stiller also believes the “disability” of kidney disease is one that will diminish over time. He cites four major breakthroughs coming in the not-so-distant future that will dramatically improve the lives of kidney patients. 1. Genomics: “Polycystic disease, hereditary nephritis, membranous glomerulonephritis and diabetic kidney disease all have a fundamental metabolic and structural abnormality. Once we find the pathways by which they are formed, we will be able to search for and design a molecule to block them—and we will find that out through genomics.” He predicts this will happen within 10-15 years. 2. Stem cell rejuvenation: “Using stem cells, we can already form nephrons under the skin in mice. Now we need to be able to do that within the structure of the kidney. It’s a matter of time. My bet is there will be a clinical trial on stem cells and kidney disease in the next five years.” 3. Implantable artificial kidney: “Using a combination of nanotechnology and stem cell technology, we will be able to produce something which can be hooked up into the vascular system to purify the blood. My estimate is this will happen in about 10 years.” 4. lncreasing the lifespan of a transplanted kidney: “Although cyclosporine and rapamycin have changed the incidence of acute rejection, the incidence of chronic rejection hasn’t really changed, and the half-life of a transplanted kidney is still 10-11 years.” Dr. Stiller believes this can be doubled through a combination of more precise suppression regimes and a better understanding of the biomarkers that first indicate rejection. “I expect we’ll be able to double the life of a transplanted kidney within the next 5-10 years.”  www.kidney.ca/ontario

MEDICAL RESEARCH

Investing in Research Research is the beginning of all scientific advances. It opens the door to a better future for patients living with kidney disease, and for their families.

he founding members of The Kidney Foundation believed that research was needed to better understand the causes of kidney failure and seek new knowledge to aid in the treatment of kidney disease. In the early 1960s transplantation was experimental at best, and dialysis was not accessible for everyone, a diagnosis of kidney disease was near fatal. Research takes time, and while it might seem that progress is slow, we’ve made tremendous strides in the treatment of kidney failure over the last 50 years. Research has led to the development and perfection of dialysis treatment. Not only is treatment accessible by everyone, but people can choose different types of dialysis that best fits their needs and lifestyle. It has made transplantation the treatment of choice for an increasing number of patients, and has led to the development of the anti-rejection drugs that have made kidney transplants so successful. All of these advances, as well as countless others, would never have been made were it not for thousands of hours and millions of dollars first being spent on basic and clinical medical research. In 2013-2014, The Kidney Foundation supported 92 research projects across Canada investing $4 million in research, plus over $3 million more by partners. Pooling resources with like-minded partners powers transformative change. It’s why we help fund nation-wide research networks and programs. In doing so, The Kidney Foundation leverages donor dollars to invest in innovation that could result in the best possible public benefit. It’s research we couldn’t do alone; but it’s research we can help make happen. Led by Dr. Lori West (Edmonton) and Dr. Marie-Josée Hébert (Montreal), The Canadian National Research Transplant Program (CNRTP) is www.kidney.ca/ontario

one of these opportunities. The program brings together a vast network of 100+ investigators across nine provinces, as well as patients and their families, with a goal to transform the field of research. Ontario is fortunate to have a very vibrant kidney research community. Thirty-four Ontariobased research projects are currently being supported by The Kidney Foundation. The Kidney Foundation funds research projects related to many areas of kidney disease including transplantation, dialysis, kidney biology, diabetes, high blood pressure, genetics and urology. The Kidney Foundation provides three types of funding: • Operating Grants provide financial support to researchers. The money is used for the salaries of support personnel such as technicians and statisticians, and to purchase supplies and equipment. • Fellowships provide salary support for Allied Health professionals such as dietitians, nurses, social workers and transplant coordinators who are pursuing doctoral degrees that focus on kidney diseases as well as on patients suffering from them. • Scholarships support outstanding Allied Health professionals who are in a masters program. Visit www.kidney.ca/research to learn more. 

Photo credit: Photos.com

Summer 2014 / Kidney Living /

THE FOUNDATION OF KIDNEY CARE

Quot es, Not es Anecdot es

Dr. John Dossetor

Research Game Changers “In the early days, transplants from deceased donors only had about a 50 percent, oneyear success rate. Today, thanks to research advancements, one year success rate is over 85 percent. In 1958 Dr. John D. Dossetor coordinated a team at the Royal Victoria Hospital in Montreal for the first kidney transplant in the Commonwealth. The transplant between identical twins was a success. The ability to successfully transplant kidneys from non-related or deceased donors was borne from refined tissue matching technologies and development of effective immunosuppressive drug therapies. In the late 1970s Dr. Calvin Stiller organized the first North American trial of the immunosuppressant drug cyclosporine in kidney transplantation, which led to its world-wide adoption.” Source: Research Game Changers Article; A Future Without Failure (2012).

Has your car reached the end of the road? “Donate your unwanted vehicle to Kidney Car like I did. It’s convenient, helps the environment, and best of all, supports The Kidney Foundation. Now that’s a hat-trick we can all celebrate.”

Donate it to the Kidney Car program! • FREE AND FAST TOWING • VALUABLE TAX RECEIPT • VEHICLES OF ANY AGE OR CONDITION ARE ACCEPTED • ENVIRONMENTALLY-FRIENDLY PROGRAM Donating your old car or truck couldn’t be easier!

Visit www.kidneycar.ca or CALL 1-866-788-2277 (CARS)

20 / Kidney Living / Summer 2014

www.kidney.ca/ontario

COMMUNITY HIGHLIGHTS

community highlights Celebrity Men Walk the Catwalk in Support of The Kidney Foundation u Thank you all so much for your efforts, enthusiasm, generosity and commitment to The Kidney Foundationâ&#x20AC;&#x2122;s Annual Celebrity Men Fashion Event. Events held this spring in Sarnia and Kitchener-Waterloo raised $38,000 to support kidney research, programs and services. Tickets are now on sale for Londonâ&#x20AC;&#x2122;s Celebrity Men event on October 16, 2014 at www.kidney.ca/ celebritymen.

Celebrity Men Fashion Event - Kitchener-Waterloo

Celebrity Men Fashion Event - Sarnia www.kidney.ca/ontario

Summer 2014 / Kidney Living /

COMMUNITY HIGHLIGHTS

Pitching in to support the Pembroke Kidney Walk

Joining Dr. deVeber are Ontario Branch Executive Director Jim O’Brien, at left, and Branch President Terry Young. Eastern Ontario 50th Anniversary of Hope

Celebrating 50 years of People, Passion and Progress

The 50th Anniversary Celebration of Hope event was well attended by the kidney community in Ottawa. Special thanks to Trillium Gift of Life Network and the Bertram Loeb OrganTissue Donation Institute for sponsoring this successful event that raised $32,000 for kidney disease research and patient programs.

The Kidney Foundation of Canada’s Ontario Branch spring leadership conference included a 50th Anniversary Celebration. We were honoured to be joined by Dr. George deVeber (centre), one of the founders of The Kidney Foundation of Canada Ontario Branch. The Branch got its start shortly after the National organization was officially founded in Montreal in 1964.

Sarah Conway and Heather Esdon, attendees at The Kidney Foundation of Canada Eastern Ontario Chapter 50th Anniversary Celebration of Hope dinner

22 / Kidney Living / Summer 2014

p Team Suds, a Kidney Walk team and driving force for the Pembroke Kidney Walk organized a slo-pitch tournament in July to raise funds for the Kidney Walk. The team walks in honour of husband and father Don Sutherland. The tournament raised $4,000, a tremendous start to their walk fundraising.

The Kidney Foundation of Canada, Ontario Branch 2014 – 2015 Board of Directors

Executive Terry Young, President Harvey Thomson, Past President Greg Robbins, Vice President Niloufer Bhesania, Treasurer Directors at Large Roza Berkowitz Ethel Doyle Debbie Hodgins Craig Kerr June Martin Dr. Judith Miller Ken Mylrea Shirley Pulkkinen Dr. Faisal Rehman Susan Storey Susan Tkachuk Executive Director Jim O’Brien Ontario Branch 1599 Hurontario St. Suite 201 Mississauga, ON L5G 4S1 1-800-387-4474 905-278-3003 www.kidney.ca/ontario

COMMUNITY HIGHLIGHTS

September

For details about these and other events in your community, call The Kidney Foundation of Canada office nearest to you, or visit www.kidney.ca/ontario.

August 13

Kidney Connect Peer Support Group, Kitchener 15 3rd Annual Ian Hay Memorial Golf Tournament, Cambridge 16 Fish for Life Derby 2014, Shebandowan Lake 16 Pub Night, Ottawa 19 Kidney Connect Peer Support Group, Thunder Bay 20 Kidney Connect Peer Support Group, Oshawa 23 The 11th Annual Rick Gatenby Memorial Golf Tournament, Niagara Falls 28 Kidney Connect Peer Support Group, Kitchener

6 Cruisin for Kidney, Timmins 6-28 Kidney Walks 9 Kidney Connect Peer Support Group, Kitchener Kidney Connect Peer Support Group, Kitchener 14 Chinese Renal Association Kidney Health Information Display, Toronto 17 Kidney Connect Peer Support Group, Thunder Bay 17 Kidney Connect Peer Support Group, Oshawa 19-20 Albert Au’s Fundraising Concert for The Kidney Foundation of Canada, Toronto 24 Kidney Connect Peer Support Group, Kitchener 29 Kidney Connect Peer Support Group, Mississauga

November 6

12 19 19 19 27

The Golden Gala – 50th Anniversary Celebration, Toronto Artilicious! Windsor Kidney Connect Peer Support Group, Thunder Bay Kidney Connect Peer Support Group, Oshawa Kidney Connect Peer Support Group, Mississauga Impressions 2014, Hamilton

December 9

Kidney Connect Peer Support Group, Thunder Bay Kidney Connect Peer Support Group, Oshawa

February 2015 22

Chinese Renal Association Chinese New Year Dinner

October 15

16 21

Kidney Connect Peer Support Group, Oshawa Celebrity Men in a Fashion Event, London Kidney Connect Peer Support Group, Thunder Bay

COMMUNITY CONTACTS Ontario Branch 1599 Hurontario St., Ste. 201 Mississauga, ON L5G 4S1 1-800-387-4474 905-278-3003 kidney@kidney.on.ca African-Caribbean Kidney Association

1-800-387-4474 Ext. 4140 acka@kidney.on.ca

Chinese Renal Association

519-344-3462 ehayter@kidney.on.ca

Eastern Ontario 613-724-9953/1-800-724-9953 bhill@kidney.on.ca

Sault Ste. Marie

Hamilton & District 1-800-387-4474 Ext. 4969 jfraser@kidney.on.ca Kingston 613-542-2121 kmccloy@kidney.on.ca

Brampton

Niagara & District 1-800-387-4474 Ext. 4969 jfraser@kidney.on.ca

Brant County 1.800.387.4474 ext. 4130

North Bay 1-800-387-4474 Ext. 4110 northbaykidney@gmail.com

1.800.387.4474 ext.4120

Central Ontario

1-800-387-4474/905-278-3003 kidney@kidney.on.ca

www.kidney.ca/ontario

Sarnia-Lambton

1-800-387-4474 Ext. 4977 pchan@kidney.on.ca

Northern Superior

705-949-0400 tmcmillan@kidney.on.ca Southwestern Ontario

519-850-5362 rramzanali@kidney.on.ca Timmins-Porcupine

705-235-3233 tpkidney@ntl.sympatico.ca Windsor & District

519-977-9211 emuscat@kidney.on.ca Western Ontario (Kitchener/Waterloo)

1-800-387-4474 Ext. 4969 jfraser@kidney.on.ca

807-624-2680 mharms@kidney.on.ca

Summer 2014 / Kidney Living /

1 in 10 Canadians has kidney disease. Walk for someONE you love

Join us at a Kidney Walk in your community each fall. Together, we can inspire hope and raise funds for innovative research, vital programs, and services that support people living with kidney disease. Registration is now open!

www.kidneywalk.ca

I am O

e is My wif

I am O

ONE

I care fo

r ONE

Taking Steps, Inspiring Hope. Join us in September in a community near you.

www.kidneywalk.ca

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Postmaster: Please return undeliverable Canadian addresses to The Kidney Foundation of Canada, 1599 Hurontario St., Ste. 201, Mississauga, ON L5G 4S1