Kidney disease impacts 30 million Americans. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the overall prevalence of chronic kidney disease (CKD) in the general U.S. population is 14 percent.
"People don't talk about kidneys the way they do other organs like the heart and lungs, but almost everyone knows someone impacted by kidney disease," said Heather Corum Powell, CEO of the Tennessee Kidney Foundation (TKF). "The rate of kidney disease increases 10-15 percent every year," she continued, noting diabetes, hypertension, and aging are all risk factors for developing CKD.
The Tennessee Kidney Foundation is there to support patients and providers through a variety of educational resources and funding mechanisms to ensure patients receive the lifesaving care needed. "We serve a 40-county area throughout Middle Tennessee. Our mission is to empower and support those at risk or affected by kidney disease," Powell said.
She added the organization considers all its programs to be preventative - whether that is primary, secondary or tertiary prevention. On the primary prevention front, TKF provides education about maintaining kidney health through exercise, maintaining stable blood pressure, exercise, healthy diet, and avoidance of sugary drinks.
Health screenings are a key component of secondary prevention with TKF volunteers setting up at health fairs, churches and community gatherings across the region. After completing an intake form, individuals move to the next station for a blood pressure check and height and weight measurements. Next, participants stop at the urinalysis station. "We have a dipstick testing machine that tells us in about 30 seconds if someone has normal, abnormal, or very abnormal urinalysis results," explained. Powell.
The last station is a one-on-one conversation with a physician or nurse to discuss results and holistic measures to maintain or improve kidney health. Powell said about 20 percent of people who go through TKF screenings have abnormal or very abnormal results. "We're not a referral organization, but we want to make sure you get follow-up care within a certain amount of time," she said, noting the clinicians stress the importance of seeing a primary care physician for additional testing and monitoring.
Primary and secondary prevention are so important, said Powell, because kidney disease rarely makes itself known in the early stages. "It's called the silent disease because it's very asymptomatic. People often don't know they have it until it's too late, and their kidneys are failing," she said, adding 90 percent of people who have kidney disease don't realize it.
For those who have progressed to the point where their kidney disease is evident, Powell said TKD offers a number of supports as part of their tertiary prevention plan, including transportation services. "We actually pay 100 percent of transportation costs for dialysis and transplant patients," she said. "The cost of transportation to get back and forth for those who can't drive themselves is just astronomical."
She added transportation is often the biggest barrier to care for dialysis patients. For someone on hemodialysis, it's pretty standard to have three treatments per week for a total of 12-14 treatments monthly. With an average transportation cost of $10, it quickly adds up ... often to a point that is unsustainable for the patient. "When people can't afford their treatment, what happens is they sacrifice that treatment. Dialysis is life or death. Thinking about someone who doesn't know if they can stay alive because they cant afford to get to their treatment is something we just can't let happen," she stated.
To combat that problem, TKF works with MTA's Access Ride program in Davidson County, buying about 1,500 tickets per month. In surrounding counties, the team works with other solution providers including transport companies. "This year we'll provide about 46,000 trips," Powell said.
TKF also helps address other social needs. With the amount of time required for dialysis, many patients with kidney failure are unable to work full time. The organization has a grant application mechanism to assist with utilities, rent, medication costs or food in emergency situations.
Spring is always a key time to drive awareness about the disease and services offered by TKD. March is Kidney Awareness Month and that leads right into April, which is Organ Donation Month. "The only treatments for kidney failure are dialysis and transplant. Of all the people in the country who need a transplant, 90 percent need kidneys. It's amazing to be able to give the gift of life while you're still living," she said of the unique opportunity to be a kidney donor.
Just as TKD hopes to increase kidney education among individuals, Powell said it's equally important to raise awareness with clinicians. "We'd like for providers who have patients who present with hypertension or diabetes to bring kidney health into the conversation early and often," she said. "Kidney disease - if it's caught early - is maintainable, and prevention is doable. But once you get to kidney failure, there's really no going back."
For Powell, the mission is personal. "My mom was diagnosed with kidney disease over 30 years ago. She's one of those unique people who never progressed to dialysis or transplant," said Powell, noting medication and lifestyle modifications have kept her mother stable. "Now 67 years old, she's atypical ... but that's how I know the importance of these early detection programs. If she hadn't been told of her kidney disease early on, I don't know if we'd still have her today."
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