Proactive Kidney Care: A Comprehensive Approach
Chronic kidney disease (CKD) is a silent epidemic, often progressing undetected until it reaches later stages when only a kidney transplant or dialysis can sustain life.
But a resilient solution is breaking through, one that focuses on prevention, early intervention, and a collaborative approach that promises to rewrite the story of this disease that affects an estimated 35 million adults in the U.S. At the heart of this shift is a growing recognition that kidney care must extend far beyond dialysis.
Moving Away from a Reactive Approach
“For too long, kidney care has been a reactive game,” Amy Schuerman-Gen, MD, chief medical officer for DaVita Integrated Kidney Care (IKC), says. Often, patients only encounter a nephrologist after kidney function falls so low that they are close to needing a kidney transplant or dialysis to sustain life. “This delay limits treatment options,” Dr. Schuerman-Gen says. “And it has profound impact on patient well-being and places an enormous strain on the healthcare system.”
DaVita IKC focuses on holistic, comprehensive care models, often in value-based arrangements, to provide proactive, wrap-around services. Changing the reactive approach to kidney care has centered on developing more robust proactive, preventive care approaches. DaVita, including its DaVita IKC programs, sits at the forefront of this transformation, with broad investments that emphasize early detection, risk factor management and collaborative care to slow CKD progression and — when possible — prevent the need for dialysis. Underpinning these investments is robust collaboration across healthcare with primary care providers (PCP), nephrologists, nonprofit organizations and others to create a seamless and patient-centered care system.
“Collaboration is the linchpin of this new era in kidney care,” Dr. Schuerman-Gen says. “Seamless communication and shared decision-making across physicians and care teams are crucial.”
The landscape of CKD treatment continues to change, including through innovations in medications. Diabetes and hypertension continue to be the leading risk factors and causes for CKD and managing these health needs remain critical. Recently, the FDA approved the use of a semaglutide medication for reducing the risk of major cardiovascular events, including kidney disease progression, in adults with type 2 diabetes and established cardiovascular disease.
“Advancements like this offer new hope and illustrates the importance of exploring innovative therapies,” Dr. Schuerman-Gen says. “It is also where the power of cross-functional care teams truly shines. Effective medication management is not a solo endeavor: It requires PCPs, nephrologists and a comprehensive care team like DaVita’s to work in concert.”
PCPs can identify potential drug interactions and tailor medication regimens to individual needs while nephrologists bring specialized knowledge of kidney function and can help adjust dosages and monitor for potential side effects. DaVita, with its focus on comprehensive kidney care provides valuable support in medication adherence, patient education and care coordination — all within the framework of a holistic care strategy.
Understanding the Power of Education
Effective upstream kidney care hinges not only on early detection and intervention but also on patient empowerment. People living with or at risk for CKD need access to comprehensive education to better understand their health needs, make informed decisions with their caregivers and actively participate in their care plans. This is where programs like Kidney Smart® play a vital role.
“When someone faces an advanced CKD diagnosis and hears they may need to start dialysis in the near future, it can spur fear and uncertainty,” Francesca Tentori, MD, MS, vice president of DaVita outcomes research and patient empowerment, says. “With Kidney Smart, we aim to replace that fear with knowledge. We want to provide a roadmap that can help them navigate the complexities of the disease and engage meaningfully with their care providers.”
Recommended to people living with CKD, this no-cost class that is available in-person, online or by telephone provides valuable information about understanding CKD and the importance of early intervention; nutrition and diet's role in kidney health; medication management and adherence; managing comorbidities like diabetes and hypertension; incorporating beneficial lifestyle modifications; and understanding treatment options, including dialysis and transplantation.
“We see firsthand how education can improve health outcomes and help reduce anxiety for someone facing a new kidney disease diagnosis,” Arlene Valdivia, patient education educator says. “It’s truly rewarding to see the impact as we provide people with the tools and knowledge they need to make informed decisions with their doctors to manage their care.”
By empowering patients with knowledge, programs like Kidney Smart, complements the collaborative care provided by PCPs, nephrologists and others within an individual’s care team.
“Effectively managing CKD in a proactive, preventive way requires a network of solutions,” Dr. Schuerman-Gen says. “Our approach to kidney health management brings together education and a patient-centered approach, which ultimately leads to better outcomes and quality of life for patients with kidney disease.”
