Table 4.

Opportunities, Challenges, and Potential Solutions to Delivering Optimal Kidney Care in Canada.

Opportunities	Challenges	Potential solutions
Solid health system: UHC system and well-developed infrastructures for care delivery	Lack of a national surveillance strategy for CKD burden and care facilities. Limited coverage of drugs for conditions that may lead to CKD, or for patients with CKD.	National CKD registry needed to facilitate better comparative studies across provinces and care facilities. CORR capacity could be extended to cover this important gap. Improve coverage for adults aged 18-65 years, particularly those with lower income or limited insurance coverage. Furthermore, negotiate lower drug prices when purchasing products from pharmaceutical companies.
National initiatives led by patient organizations (eg, the SeeKD targeted screening program by the Kidney Foundation of Canada has produced the first national targeted screening program in Canada for CKD). Its goal is to collect data and information about screening and prevention, early detection, and management of CKD across Canada	Limited workforce planning and guideline in terms of how hemodialysis units and CKD clinics are staffed and operated, and what intensity of resource should be applied.	National Kidney Care Policy addressing the key domains of UHC.
National initiatives led by professional organizations, and collaborative networks of patients, providers, and policymakers. For example, existing networks to share information and resources and tackle national problems collaboratively at a country level through the Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) initiative	Variations in kidney care and workforce structures. The health-care systems of all provinces function in silos, and even within provinces huge variation exists between hospitals.	Development of a national strategy and standardization of care organization to monitor quality targets, structures, workforce needs.

Note. CKD = chronic kidney disease; CORR = Canadian Organ Replacement Registry; UHC = Universal Health Care; SeeKD = See Kidney Disease.