When it comes to kidney disease, prevention and early detection is crucial.
That’s the message that LaVarne Burton, president and CEO of the American Kidney Fund is working to impart during National Kidney Month.
Burton raises awareness at a time when an estimated 26 million Americans have chronic kidney disease. The main function of kidneys is to remove wastes from the body. When someone has chronic kidney disease, wastes can build up in the blood and make the person sick.
“Our job at the American Kidney Fund is to do everything that we can to increase awareness and support people by providing information and the information that we want to get out this month is that if you have diabetes and high blood pressure you are at very high risk and you need to get tested,” said Burton.
African Americans are about four times more likely to suffer from kidney disease than other groups. Hypertension and diabetes are the two factors that have contributed to the rates of kidney disease among Blacks.
“While we are at particularly high risk because of those diseases, we also have to understand that this disease is one that is highly preventable. This is a disease that we can control. We can control this by working with our doctors and healthcare providers to control those diseases that put us at risk. We can make changes in our lifestyles —by controlling our diet, watching our weight — all the things that contribute to a healthy lifestyle,” stressed Burton.
“The major concern that we have in taking care of patients with chronic kidney disease is the fact that it is a silent disease. People just don’t know they have it,” said Dr. Ed Jones, nephrologist and medical director for Fresenius Medical Care North America, an operator of dialysis clinics.
Jones said that physical symptoms of kidney disease don’t show up until the kidneys are operating below 20 percent of their normal capacity. Symptoms include loss of appetite, weight loss, itching of skin and change in sleep pattern.
“We probably haven’t done as good a job in educating patients about the fact that the only way they’ll know that they have chronic kidney disease is to get tested,” Jones said.
“The fortunate thing is that we can stabilize and cut down on the progression of the disease. We have tools to be able to slow the disease,” said Jones.
He also recommends that people who have a family history of kidney disease be tested for the condition.
Two tests are used to check for kidney disease. The first is a blood test that checks to see how well a person’s kidneys are filtering. The second test checks for a protein that can pass into urine when kidneys are damaged.
Kidney disease can lead to end stage renal disease, which occurs when the kidneys no longer work at a level needed for day-to-day life.
About 400,000 Americans with end stage renal disease rely on some form of dialysis, where a machine takes over many of the kidneys jobs including filtering excess waste and fluid. Patients typically undergo four-hour long dialysis sessions about three times a week.
When you look at the outcomes of patients who are dialysis in the United States about 20 percent of those patients die each year because they are not adequately prepared for the procedure, Jones said.
Jones says dialysis patients will have better outcomes if they are prepared to get a fistula, a site that is surgically created on the body where blood is removed and returned, as opposed to using a temporary IV that could become infected.
“Educating the patient to get the right type of vascular access for dialysis is a major factor and making sure that they are taking their medication so that their blood pressure is controlled is a key factor for their outcome,” Jones said.
People on dialysis also face conditions such as anemia and osteoporosis which must be treated with multiple medications.
The ultimate goal is to prepare people who are facing kidney failure for an organ transplant. However the United Network for Organ Sharing notes that more than 90,000 people are on the waiting list for a kidney transplant. According to the U.S. Renal Data System, only 18,000 people get a new kidney every year.
In Pennsylvania, there are about 15,000 people on dialysis. The National Kidney Foundation notes that African Americans constitute more than 31 percent of all patients in the U.S. receiving dialysis.
In addition to raising awareness, the American Kidney Fund (www. kidneyfund.org) also provides financial assistance to people with kidney failure. According to Burton, last year the organization assisted more than 1,000 Philadelphia residents and provided about $3 million in financial assistance for health insurance, medications and transportation costs. Burton says the cost of caring for kidney failure is approximately $100,000 a year.
“We want to help people not just in terms of dollars but in terms of the burden that it imposes on families. Many people who are in kidney failure have to go on dialysis and are no longer able to work, so you also have that economic burden on the family,” she added.