How can we preserve kidney function?
Preserving kidney function is all about empowering the patient, and that’s why Empowered Kidney Care is turning the traditional approach to nephrology on its head. Rather than focusing solely on dialysis and end stage renal disease (ESRD), EKC is moving “upstream” to treat early-stage chronic kidney disease (CKD) and preserve kidney function.
This concept isn’t just a nice idea, after an initial period of six months with real-time data, the results of empowered CKD management speak for themselves: “In six months, we haven’t put a single patient on dialysis,” reports EKC president, Dr. Richard Gibney. “Empowering the patient, along with game-changing new medications, is the key to success in preserving kidney function.”
If it’s so effective, why is this approach so underutilized? How can the American kidney care system make a change for the better?
The problem with traditional kidney care
For decades, CKD has received little attention until it’s time for a patient to begin dialysis. In fact, data from CMS shows that 92% of patients with CKD stage 1-3 are unaware that they even have kidney problems.
“92% of patients with CKD stage 1-3 are unaware that they have kidney problems.”Centers for Medicare and Medicaid Services
“This statistic is completely outrageous,” says Dr. Gibney. “We can do better. Waiting to address CKD until it’s time for dialysis is like waiting to address circulation issues until gangrene sets in and it’s time to amputate a limb. There are simple things we should be doing right now to keep the problems from getting any worse.”
As a kidney specialist practicing nephrology in Waco, Texas for over 40 years, Dr. Gibney typically didn’t see patients until their disease had progressed to advanced CKD. By that time, prevention is no longer an option. Transplant or hemodialysis are the only ways to support kidney failure.
This led Dr. Gibney to ask, “What if we’ve got it all wrong? What if the solution to this problem is further upstream?” This question is why Empowered Kidney Care exists today: to empower patients and providers to preserve kidney function before kidney disease progresses to the point of dialysis or transplant.
Building the right team to combat kidney disease
If studies show that 92% of CKD stage 1-3 are unaware of their kidney problems, that means relevant test data is already available. If indicators of kidney decline are so easily traceable in existing standard lab work, why were these patients kept in the dark?
There is clearly a gap in communication between this regular lab work and long-term patient outcomes. At EKC, we believe that primary care physicians (PCPs), endocrinologists (diabetes specialists), and cardiologist (heart specialists) are poised to stand in that gap.
PCPs in particular are unique in that, unlike specialists, they maintain long-term relationships with patients. They are like the quarterback of the healthcare system – they parse information, coordinate players, and execute plays for the patient.
PCPs can help close this awareness gap surrounding kidney disease by creating systems that identify potential kidney problems and early warning signs, such as blood pressure, albumen in the urine, and decreased Glomerular filtration rate (GFR). This, combined with proper medication reconciliation (making sure records accurately reflect what a patient is prescribed), are crucial steps in not only detecting potential health issues, but preserving the current health of a patient’s kidneys.
A key to moving upstream of kidney disease, therefore, is not only about empowering the patient, but also about empowering a collaborative healthcare team that supports them. If they can catch early warning signs, they can help educate the patient and walk alongside them to make healthy lifestyle and medication choices that preserve kidney function.
To aid healthcare workers in further empowering patients, we have developed an Empowered CKD Management Protocol. This document outlines ways in which their team can continue to move upstream by watching for indicators such as hypertension, diabetes, and obesity. This protocol is designed to empower providers, which in turn empowers the patient.
Empowering the patient
Empowerment is a lifelong process, but it starts with a few simple steps. A key element of our upstream approach to preserving kidney function is simple patient “homework” that needs to be completed for each doctor visit:
- Health Data: Patients track and bring their own health data (blood pressure, blood sugar, and weight) to their appointment. This requires them having their own devices and knowing how to properly use them.
- Medications: Patients bring their medication bottles to each visit so that they can discuss what they are, how they take them, and why they are taking them.
- Patient advocate: Patients bring a close friend or family member for love and support.
These three assignments are key to patient empowerment. Rather than waiting for kidney function to deteriorate, patients have important work to do. By being active, rather than passive, they gain a sense of pride and control over their own outcomes. “I haven’t had anybody say they don’t want to be involved in their care,” Dr. Gibney noted.
Join the empowered kidney care movement!
Today in the United States, an estimated 37 million people suffer from chronic kidney disease or end stage renal disease. This means there are abundant opportunities to empower patients and help them gain control of their health and preserve kidney function.
If you are a patient or provider that is interested in learning more about our Empowerment Protocol, don’t hesitate to contact us or check out our empowerment resources:
Download the CKD Empowerment Checklist (for patients and providers)
Download the Empowered CKD Management Protocol
Join the empowered movement and help us move patients upstream of kidney disease!