Update: 1 Year of Preserving Kidney Function
This month marks a significant milestone for Empowered Kidney Care and the patients at the University of Texas Health Science Center in San Antonio, Texas. Dr. Richard Gibney joined the faculty with an audacious goal to preserve kidney function and keep patients off dialysis. One year later, the results are in and even better than anyone expected.
12 months of empowered kidney care
Dr. Gibney and his team continue to expand their patient base, focusing on preserving function for patients with CKD. Their patients primarily come from the low-income “barrios” around San Antonio, a population with high risk for heart problems, obesity, diabetes, and kidney disease:
- Total Patients: 587
- Office Visits: 1,124
Effective medications and patient empowerment remain the first line of defense:
- Ace/ARB Prescribed: 226 (38%)
- SGLT-2 Prescribed: 235 (40%)
- Fully Empowered Patients: 362 (61%)
Additional health and care data includes:
- Conservative Care: 12 (2%)
- Edema/CHF: 86 (15%)
- Proteinuria (UP/UC)>500 mg: 83 (14%)
- Diabetic Patients: 379 (65%)
- Hypertension Patients: 504 (85%)
Thanks to revolutionary new medications and a caring team, many patients have been able to preserve kidney function and slow the progression of their disease.
- Empowered patients starting dialysis: 0
Over this first 12-month period, only six patients had to start dialysis, and each of them first came to the clinic with end-stage renal disease (ESRD) and a GFR less than 9.
- ESRD patients starting dialysis: 6 (1%)
How might their stories have been different if someone had reached out to them when their GFR was still 80 or even 25? Together, we advocate for a culture that encourages early identification and preventative action. It’s up to patients and healthcare providers to be proactive. Kidney disease is silent.
Taking advantage of new drugs to preserve kidney function
Effective kidney drugs have been available for many years, but they are still underutilized around the nation. Ace and ARBs remain a staple of kidney health, but Dr. Gibney and his team have added one more: the extremely promising SGLT-2 Inhibitors. They prescribe this new drug to patients with GFRs as low as 25, and the results have been outstanding.
Ace and ARBs have been around since the 1980s, but they are still only prescribed to 40-45% of CKD patients. In just 12 months, the UT Health Science Center team has prescribed SGLT-2 Inhibitors to 235 patients, matching the 40% historic adoption rate of Ace/ARBs.
Despite their potential, some doctors are still hesitant to utilize SGLT-2 Inhibitors because of an increased risk for urinary tract infections (UTIs). The San Antonio team does not prescribe the drug to women with a history of chronic UTIs, and they have only experienced two instances of the infections while on SGLT-2s.
“For these patients, we discontinue the SGLT-2s and treat the infections with standard antibiotics,” explains Dr. Gibney. “Everything has cleared up quickly with no additional problems. These drugs have shown tremendous results which absolutely outweigh any minor risks for people who don’t have problems with UTIs.”
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