When a 49-year-old woman attended Dr. Phil McFarlane’s multi-care kidney clinic with polycystic kidney disease, she had multiple health issues, including chronic flank pain and fatigue, and had been to the emergency room multiple times.

She was dealing with a “high anxiety burden” from her health issues, the financial burden from the necessary medications and the difficulty maintaining stable employment while dealing with her disease. Her story represents the challenges faced by Canadians living with chronic kidney disease, said McFarlane (pictured right), a clinical investigator in the nephrology division at St. Michael’s Hospital and an assistant professor at the University of Toronto, during Benefits Canada’s 2025 Chronic Disease at Work conference in a session sponsored by Otsuka Canada.

Read: Coverage of the 2024 Chronic Disease at Work conference

One in 10 Canadians — or four million people — lives with chronic kidney disease, a progressive degradation of the kidneys. While it’s typically perceived as an older person’s disease, working-age Canadians can be diagnosed with CKD. Once someone’s kidneys reach 10 per cent function, they’ll need to go on dialysis.

Diabetes is the most common cause of CKD, said McFarlane, noting half of all people with diabetes will show signs of CKD in their lifetime. Hypertension is also a significant cause, he noted, and a host of other chronic diseases can also lead to CKD.

He said doctors now have six strategies for delaying or stopping disease progression, including four “extremely effective” classes of drugs: ACE inhibitors and ARBs, SGLT-2 inhibitors and phenerenone. All four classes are typically covered by private plans. Last year, physicians learned Ozempic is also effective in slowing the loss of kidney function.

Private coverage for genetic testing can also be helpful in early identification of gene mutations associated with higher risk of CKD, said McFarlane.

Read: Expert panel: Chronic disease management, GLP-1s among 2025 health benefits trends

For employees who are living with CKD or caring for someone with the disease, flexible schedules and the option to work from home are useful accommodations, particularly for those dealing with the time commitments of dialysis or specialist visits, said Neda Nasseri (pictured left), pharmacist and product director for drug benefits at Desjardins Insurance, also speaking during the session.

Employers can also play a valuable role in education, such as by partnering with the Kidney Foundation of Canada, said McFarlane, given that roughly 90 per cent of people with CKD don’t know they have it.

He noted that employers have tended to be “very supportive” of employees who need time off to donate a kidney to a friend or family member. That was true in the case of his patient with PKD, when her family member donated a kidney.

Read more coverage of the 2025 Chronic Disease at Work conference.