Deloitte projects CKD costs will reach $17.6 billion by 2050 without better detection and care
More than 90 percent of early-stage chronic kidney disease cases in Canada go undiagnosed — and that gap is costing the economy $11.7bn a year.
A November 2025 Deloitte report commissioned by the Kidney Foundation of Canada puts the full economic toll of CKD at $7.6bn in direct healthcare costs and $4.1bn in indirect costs annually, the latter driven largely by lost productivity and informal caregiving.
Of the $2.6bn in productivity losses, $2.0bn comes from patients unable to work, according to Deloitte's analysis using the Inside CKD economic model.
CKD affects over 4 million Canadians and ranks as the 11th leading cause of death in the country, responsible for close to 8,000 deaths in 2021, according to Statistics Canada and Global Burden of Disease data cited in the report.
End-stage kidney disease (ESKD) cases rose 40 percent between 2014 and 2023, with over 49,000 Canadians living with ESKD in 2023, according to the Canadian Institute for Health Information (CIHI).
The cost structure of CKD is stark.
Deloitte found that direct management costs for diagnosed patients range from $5,000 to $7,000 per year at Stage 3, to over $50,000 per year for Stage 5 patients on dialysis.
The first year of a kidney transplant can exceed $100,000, according to a 2022 study by Koto et al. in Cost Effectiveness and Resource Allocation.
CIHI reported in 2016 that annual dialysis costs run between $60,000 and $100,000 per patient depending on modality.
A 2017 study by Manns et al. in the Canadian Journal of Kidney Health and Disease found 80 percent of Canadians with kidney failure on dialysis were unable to work, with disability benefit payments totalling at least $217m annually.
Informal caregiving added an estimated $1.5bn in indirect costs in 2024, Deloitte reported.
Despite this, most cases are caught too late.
A 2023 REVEAL-CKD study using the CPCSSN database found that 94.8 percent of Stage 3 CKD patients with hypertension had no recorded diagnosis within six months of initial assessment.
A 2019 study by Bello et al. in JAMA Network Open found only 18.4 percent of patients received a urine albumin test within six months of diagnosis — one of 12 quality indicators, of which only 4 were met by 75 percent or more of the patient cohort in Canadian primary care.
Deloitte modelled three improvement scenarios.
Moderate gains, a 10 percent increase in early detection, medication use, and transplant capacity, could reduce total annual costs by $1.1bn and prevent 7 percent of ESKD cases by 2050.
High-level improvements at 20 percent could save $2.1bn annually and prevent 13 percent of ESKD cases.
The largest gains come from combining high-level management improvements with broader access to newer drug therapies, including SGLT2 inhibitors, mineralocorticoid receptor antagonists, and GLP-1 receptor agonists.
That scenario could prevent 32 percent of ESKD cases and reduce annual costs by $4.1bn by 2050, the report said. Clinical trial data cited by Deloitte shows these therapies reduce CKD progression risk by 20 to 40 percent.
Yet a 2023 Alberta study by Lau et al. in CMAJ Open found only 7.1 percent of eligible adults with diabetes and CKD received SGLT2 inhibitors in 2019, with near-zero usage among CKD patients without diabetes.
Targeted screening of high-risk groups, particularly those with diabetes and remote Indigenous communities, is cost-effective, according to a 2017 study by Ferguson et al. in Kidney International.
The study found an incremental cost-effectiveness ratio of $7,790 per QALY in air-access-only Indigenous communities.
Broad population-based screening, however, is not considered cost-effective in Canada, per a 2010 study by Manns et al. in BMJ.
Without intervention, Deloitte projects total CKD costs will rise from $11.7bn in 2024 to $13.6bn by 2030 and $17.6bn by 2050.
By 2050, 6.22 million Canadians are projected to have CKD, nearly half in moderate to severe stages.
Rising diabetes rates, from 8.2 percent in 2014 to 9.6 percent in 2023, and hypertension affecting 25 percent of adults are key drivers, according to the Canadian Chronic Disease Surveillance System.
Deloitte noted that Canada lacks comprehensive national CKD surveillance data by stage, limiting planning and resource allocation.
The report does not account for intervention implementation costs, meaning projected savings represent gross reductions in disease burden rather than net program savings.
