National Kidney Foundation president urges community to ‘awaken the giant within’
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The kidney community must work together to solve the many issues facing nephrology, whether it be the COVID-19 crisis, the increasing cost of kidney care or the lack of patient awareness of chronic kidney disease, Holly Kramer, MD, MPH, president of the National Kidney Foundation, said during her address at the virtual National Kidney Foundation Spring Clinical Meetings.
“I ask you to see yourself as the giant and to see the future of nephrology standing on your shoulders — the future social workers, the future dietitians, the future nurses and nephrologists, the future researchers, the future advocates and the future patients — because we have big problems that we need to address immediately and moving forward,” Kramer said.
The kidney community also needs to recognize the contributions of previous giants in the specialty, Kramer said, including Willem J. Kloff, MD, inventor of the rotating drum dialysis machine, and Ada DeBold, who began the NKF in 1950.
With the COVID-19 pandemic, patients with an underlying illness like CKD are the most vulnerable to the virus, Kramer said. It is important to get as many patients on home dialysis as possible and to ensure those who continue to receive in-center dialysis are protected and receive the care they need, she said.
A key to improving care is breaking down the silos, Kramer said. With more than 100,000 patients waiting for a new kidney, organs that could possibly be transplanted are discarded without valid reasons, she said. Better communication between dialysis providers and the transplant community can break down those silos and allow caregivers can talk to one another. Creating kidney donation chains to help reduce the transplant waiting list are a step in the right direction, Kramer said.
Key to more transplants is reducing the cost of immunosuppressive medications, which are only paid for in the first 3 years by Medicare if a patient receiving the transplant is younger than 65 years old, she said. Patients start rationing their medications which leads to earlier graph loss and the need for more kidney transplants, Kramer said.
Lack of patient knowledge of CKD has been a continuous issue in nephrology, she noted. If patients are not aware that they have CKD, then self-management, education, therapy and medication may not be helpful.
Finally, she said research funding in nephrology is lower than all other medical specialties even though an estimated 37 million people have kidney disease. Without research, there can be no decrease in mortality or survival improvement in patients with CKD.
“You are the giant, and the future of nephrology lies on top of your shoulder. There are complex acute problems that we are going to struggle with, but we’re all in this together,” Kramer said. “We’re advocates and providers who are not afraid to disrupt the status quo. We’re not afraid to take big steps. We are a community that no matter if a global epidemic that has hit every single continent is going to keep us from fighting for our patients with kidney disease and continuing the battle to improve the lives of all patients who are suffering with kidney disease.” – by Erin T. Welsh
References:
Kramer H. Awaken the giant within. Presented at: National Kidney Foundation Spring Clinical Meetings; March 26-29, 2020 (virtual meeting).
Disclosure: Kramer reports no relevant financial disclosures.
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