At UHN, we strive to deliver Compassionate Care & Caring. Learn more about the services and supports that are available to you throughout your journey.
Our UHN programs and services are among the most advanced in the world. We have grouped our physicians,
staff, services and resources into 10 medical programs to meet the needs of our patients and help us make
the most of our resources.
At the heart of everything we do at UHN are our Healthcare Professionals. Refer a patient to one of our 12 medical programs. Learn more about the resources and opportunities available for professional growth.
University Health Network has grown to be one of the largest research and teaching hospital networks in Canada - pioneers in improving the lives of patients. Our long history of health professions education at Toronto General, Toronto Western, Princess Margaret and Toronto Rehab hospitals has consistently advanced the science of education.
University Health Network is a health care and medical research organization in
Toronto, Ontario, Canada. The scope of research and complexity of cases at UHN has made us a national and international
source for discovery, education and patient care.
Being touched by illness affects us in different ways. Many people want to give back to the community
and help others. At UHN, we welcome your contribution and offer different ways you can help so you can find one that suits you.
The Newsroom is the source for media looking for information about UHN or trying to connect with one
of our experts for an interview. It's also the place to find UHN media policies and catch up on our news stories, videos, media releases,
podcasts and more.
Toronto (May 22, 2014) – A first-ever study from a large Canadian centre found that kidney transplant recipients lived longer and had better treatment success than patients on intensive home hemodialysis, but also had an increased risk of being hospitalized within the first year.
These findings were reported in a study entitled, "Survival and hospitalization for intensive home hemodialysis and kidney transplantation", by lead author Dr. Karthik Tennankore, nephrologist at Dalhousie University, and Drs. Chris Chan and Joseph Kim, nephrologists at Toronto General Hospital, University Health Network. The study was published online on May 22, 2014 in the Journal of the American Society of Nephrology (JASN).
The research reaffirms the need to encourage patients receiving intensive home hemodialysis to pursue kidney transplantation as a definitive treatment option for end-stage kidney disease. However, the study also found that the outcomes for these specific dialysis patients were generally positive, especially when compared to patients on in-centre hemodialysis (intensive home hemodialysis patient survival was 94% and 80% at one and five years).
"For patients with end-stage kidney disease, a kidney transplant is still the best treatment option," says Dr. Chris Chan, Deputy Director, Division of Nephrology, University Health Network, R. Fraser Elliott Chair in Home Dialysis and Associate Professor of Medicine, University of Toronto. "But not everyone is a candidate for a transplant and we are facing a shortage of organs for these patients. We must continue to study and develop new and better ways to bridge the gap, and that includes developing better dialysis treatments."
Dialysis will continue to be an important treatment option for many patients, points out Dr. Karthik Tennankore, Division of Nephrology, Dalhousie University. "This study also tells us that patients who are receiving this type of dialysis still have very good health outcomes."
Due to long waiting times for kidney transplants – up to 10 years in the Greater Toronto Area (GTA) depending on blood type and other factors - the authors note that it is important to identify "bridging therapies" for patients with end-stage kidney disease.
Kidney transplantation remains the gold standard for kidney failure treatment, but intensive home hemodialysis (16 hours or more of treatments a week) is emerging as a treatment option with many clinical advantages, such as minimal adverse reactions, low rates of hospital admission and hospital stay, and superior outcomes to conventional in-centre dialysis treatment, which is usually given three times a week.
While studies have previously shown that in-centre dialysis does not have the same benefits as a kidney transplant, it is not clear how intensive home hemodialysis compares with kidney transplantation.
This observational study looked at 1,690 patients, comparing 173 patients on intensive home hemodialysis to 1,517 kidney transplant recipients from both deceased and living donors who received their transplants at Toronto General Hospital, University Health Network from 2000 to 2011.
The study found that kidney transplant patients had a 55% to 61% reduced risk of treatment failure or death during the study period when compared to the home hemodialysis patients. The risk of being admitted to the hospital and spending a longer time in the hospital was higher for some kidney transplant recipients up to a year after transplantation, likely due to surgical complications, infections, acute rejection, and other related issues. However, the risk of hospitalizations was lower for kidney transplant recipients in the long-term when compared to home hemodialysis patients, with the latter likely related to the development of late-dialysis complications.
At the time of the study, Dr. Karthik Tennankore was the Baxter - University Health Network Home Dialysis Fellow.
Toronto General Hospital is a partner in University Health Network, along with Toronto Western, the Princess Margaret Cancer Centre and Toronto Rehabilitation Institute. The scope of research and complexity of cases at Toronto General Hospital have made it a national and international source for discovery, education and patient care. It has one of the largest hospital-based research programs in Canada, with major research in cardiology, transplantation, surgical innovation, infectious diseases, genomic medicine and rehabilitation. Toronto General Hospital is a research and teaching hospital affiliated with the University of Toronto.
Phone: 416 340 4636