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NKF president: The status quo means losing ground in the kidney disease fight
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BOSTON — The National Kidney Foundation president told a large audience here at the NKF Spring Clinical Meetings, “You lean in, and we all win.”
This has never been more important because “our pace of progress is starting to slow,” Holly Kramer, MD, MPH, NKF president said.
“I look around this room and I see so many people who are really dedicated to fighting disease ... who have such passion,” Kramer said. “I need you to lean in, so we can win this battle.”
“Because if you walk into a dialysis unit, it looks basically the same as it did 20 years ago,” she said. “Maybe the machines are a little sleeker, but the treatment is basically the same and transplantation looks the same to me — same chronic immunosuppressants, same organ procurement, same way of monitoring allograft function. It is all the same.”
There are new medications to slow kidney disease progression in patients with diabetes, she noted with excitement.
She asked, “But if they are not being screened and diagnosed with kidney disease, how can those therapies be implemented?”
Kramer said the danger is that this “sameness” is coupled with an aging population and an obesity epidemic that presents a grave challenge. She said the public health reaction of the obesity epidemic is a “turtle response.”
The result is 40% of the U.S. population is now obese. She said obesity is a major risk factor for diabetes and “now 25 million people in the U.S. are going to have diabetes — our #1 risk factor for kidney failure.”
“This means that 37 million people in the U.S. have some stage of chronic kidney disease, according to the CDC,” Kramer said.
Kramer pointed to a recent Journal of the American Society of Nephrology article by Keith P. McCullough, MD, that projected by the year 2030, the ESRD incidence will increase 12% to 18%.
“That means there is going to be over 1 million people with ESRD by 2030 — 1 million people,” she said.
She called on the kidney community to look carefully at the financial disincentives of transplantation, screening, kidney discards rates and reasons preventing progression of kidney disease; the disparity of research dollars earmarked for chronic disease and increasing awareness of kidney disease in the general population.
“More than 40% of persons with advanced kidney disease, don’t know they have it,” she said.
Due to the lack of research and investment “over the past 15 years, the years of life lost due to kidney disease has increased by 69%,” Kramer said.
So, she called on the kidney community to lean into the challenges like one leans into the wind or an invisible barrier and to “keep moving.”
“Leaning in can also mean seizing opportunity without hesitation, walking up to a problem and looking right at it and saying, ‘What can I do to make this better?’... and not accepting the status quo,” she said. “You are the best person to lean in. You understand this disease,” know the patients, their families and their struggles, Kramer said.
She concluded with a call to action for providers to routinely make patients and their families aware of the NKF and encourage them to use the NKF as a resource because if they know about the foundation’s initiatives, “things will happen.”
“Congress will listen to patients,” Kramer said. – by Joan-Marie Stiglich, ELS
References:
Kramer H. Presidential address: You lean in and we all win. Presented at: National Kidney Foundation Spring Clinical Meetings; May 8-12, 2019; Boston.
McCullough KP, et al. J Am Soc Nephrol. 2019; doi:https://doi.org/10.1681/ASN.2018050531
Disclosure: Kramer is the current NKF president. She reports no relevant financial disclosures.