Mar 29, 2023
Preventing Kidney Failure Through Awareness: Exploring Efforts to Mitigate Risks and Slow Disease Progression
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In March, National Kidney Month (NKM) serves as an opportunity to take stock of the progress the health care community has made through joint efforts to reduce the number of lives impacted by kidney failure.

As it stands, the reality is that more than half of people who experience kidney failure don’t know they have kidney disease until they “crash onto dialysis”—needing to start treatments emergently in a hospital setting—or are unprepared for a kidney transplant.

“The kidney is a brilliant organ that will work overtime to maintain our health even as function declines,” says Dr. David Roer, chief medical officer of DaVita Integrated Kidney Care (DaVita IKC). “Crashes and lack of education about kidney disease are so common because it’s not uncommon to experience few—or even no—symptoms until you’ve reached kidney failure.”

As DaVita seeks to establish high-quality, patient-centric care at every stage of kidney disease, the kidney care organization has and continues to build out its chronic kidney disease (CKD) capabilities, building and proving new ways to care for people with poor kidney health before someone experiences kidney failure, including through DaVita IKC programs. To do this, they work on new care models, artificial intelligence and other technology to support clinical teams and create an ecosystem of care to identify early signs of kidney problems and begin treatment aimed at slowing the decline of kidney function.

“We cannot do this alone,” says Dr. Jeff Giullian, chief medical officer of DaVita. “We must continue to forge new relationships—with primary care providers, specialists in and outside of nephrology, and patient advocates—to support our work and help create a health care experience that creates better understanding and emphasis on kidney health.”

Many people go into their annual physicals and understand how their blood pressure, cholesterol and blood sugar levels affect their overall health, but they may not recognize the importance of having their kidney function measured and tracked.

“It’s critical the nephrology community seize opportunities to collaborate with primary care providers, other specialists and patient advocates, to convey the importance of identifying patients living with or at risk of kidney disease by evaluating kidney function through a quick blood test called a glomerular filtration rate (GFR) assessment and a simple urine test looking for excess protein.  When appropriate, these tests can be coupled with education for patients and their loved ones, explaining kidney health and what a decline in kidney function can mean including the benefits of lifestyle changes,” Dr. Giullian says.

“Our partner providers can also help these patients engage with a nephrologist proactively,” Dr. Roer says. “Because when we identify and work with people before their kidneys fail, our focus can shift from sustaining life through dialysis or transplant to protecting kidney health by delaying disease progression.  And, when the circumstance demands it, we can help people living with advanced kidney disease to make decisions that are best for them, including kidney transplants, options for home dialysis and conservative (non-dialytic) care.”

Education, like that offered at no cost through Kidney Smart® classes, can also empower people to make mindful, intentional changes in their day-to-day lives aimed at managing their kidney health—and making well-informed decisions in collaboration with their doctors. Kidney Smart has educated more than 270,000 people, providing an overview of the kidneys’ role in health, kidney-healthy diet and nutrition and treatment options if or when an individual progresses to kidney failure. According to a study published in Kidney Medicine Journal in 2022, Kidney Smart education is associated with higher rates of people starting on a home dialysis modality and lower hospitalization and mortality rates in the first year of treatment.

DaVita also continues to evolve what education entails to better meet patients where they are with an equitable experience. This includes developing materials in multiple languages, learning personal cultural context for lifestyles and dietary considerations and identifying barriers that individuals face—such as access to transportation, socioeconomic factors and more—that can significantly impact successful kidney health management.

It’s rare for chronic diseases, such as diabetes and kidney disease, to exist in a silo. Understanding that diabetes is the leading cause of CKD means recognizing the key role awareness and education can play with people who have diabetes. As part of a multi-year collaboration with the American Diabetes Association (ADA), DaVita joined forces with them as they’ve launched new education on kidney disease on the ADA site, driving awareness about the link between diabetes and kidney disease.

In addition to education, DaVita also seeks to support missions that address inequities. Approximately 10% of U.S. faces food insecurity, and that number grows to nearly one-third for low-income families.[1] To address this, nutrition education is not enough: It’s paramount to discuss and seek ways to create access to kidney-friendly foods. This becomes especially true for individuals who have kidney disease and progress to kidney failure, because their nutritional needs become increasingly complex.

Recently, the DaVita Giving Foundation—a private charitable organization—announced a $1.4 million grant to the Food is Medicine Coalition (FIMC). This grant supports FIMC’s partnered nonprofit organizations to address the dual crisis of illness and hunger. The DaVita Giving Foundation will help provide more than 100,000 medically-tailored meals to people facing this issue, including individuals with ESKD, especially in California, Minnesota and Florida.

“I look forward to more opportunities for DaVita, the DaVita Giving Foundation, and the wider kidney care community, “Dr. Giullian says, “to identify and relentlessly pursue opportunities that seek to educate communities on kidney health and transform kidney care to reduce the impact of poor kidney health and improve the lives of people living with kidney disease.”

3 Things You Can Do to Support Kidney Health Awareness—All Year Long

As the end of March draws near, it’s important to keep the spirit of NKM alive. Follow and share these three tips to promote better kidney health and kidney disease management:

1. Talk with your doctor about your kidney function. This is often included in annual bloodwork and can give you an idea of your current kidney health—and whether you may need to adopt kidney-healthy habits or connect with a nephrologist. You can also ask for a quick and simple eGFR test to determine your kidney health.

2. Learn your risk factors. Diabetes is the leading cause of kidney disease, but other risk factors include high blood pressure or a family history of kidney disease. Understanding your current health and how it can affect your kidney can help you better protect your kidney health.

3. Attend a Kidney Smart® class. Education plays a big role in kidney health management. Even if you do not have traditional risk factors or kidney disease, Kidney Smart can help you better understand family members’ or friends’ health needs if they have kidney disease.