Hot Topics in Kidney Health

How much sodium is safe for kidney patients?

Most patients on dialysis need to limit the amount of sodium in their diets. But how much sodium is safe and what are some ways to add flavor to your diet? On today's episode, our experts cover examples of high sodium foods, recommendations for low sodium substitutes, and how much sodium people with kidney disease should have as a part of a healthy diet.

In this episode, you will hear from:

Melissa Prest, DCN, MS, RDN, CSR, LDN

Melissa Prest is the Foundation Dietitian for the National Kidney Foundation of Illinois. In this role, she focuses on nutrition education for individuals at risk for and/or diagnosed with chronic kidney disease.  Melissa is also involved in program planning for patients and professionals.  Prior to working with NKFI, Melissa practiced in a dialysis center providing medical nutrition therapy for individuals treated with renal replacement therapy. Melissa completed her doctorate in clinical nutrition from Rutgers University and her master’s degree in clinical nutrition from the University of Medicine and Dentistry of New Jersey.  Dr. Prest holds multiple local, state, and national volunteer leadership roles with the Chicago Academy of Nutrition and Dietetics, the Illinois Academy of Nutrition and Dietetics, the Illinois Council on Renal Nutrition, the NKF Council on Renal Nutrition, the Renal Dietitian Practice Group and serves a as National Media Spokesperson for the Academy of Nutrition and Dietetics. “In addition to being able to form a long-term patient-clinician relationship, what I most enjoy about working with persons living with chronic conditions is seeing the impact of making healthy behavior changes on their quality of life.”

Chef Duane Sunwold

Chef Duane is a CKD patient who put his disease into remission by changing his diet and following his doctor’s recommendations. Duane is currently a culinary arts instructor at the Inland Northwest Culinary Academy.  He has spent his culinary career cooking in the Pacific Northwest and was a private chef for the Bill Gates family.  Duane has presented his culinary accomplishments to medical professionals and patients around the United States.  Duane has also participated on a PCORI research grant with Washington State University and was a core member on a CDC’s sodium reduction grant for the Spokane Regional Health District. 

For more information on sodium and a CKD diet, visit here. 

For tips on limiting your sodium, visit here. 

What do changes to eGFR calculation mean for patients?

As a kidney patient, you most likely know your estimated glomerular filtration rate, or eGFR, and that it’s a way to check how well your kidneys are working. In the past some medical calculations, including a way to measure eGFR, included race in their estimates. In September, NKF and the American Society of Nephrology announced that their joint taskforce recommended a new, race-free approach to measuring eGFR. What does this new equation mean for patients, especially those who identify as Black or African American? In this episode, we sat down with two members of that taskforce to get the facts.

 

In this episode, you will hear from:

 

Mallika L. Mendu, MD, MBA

Mallika Mendu, MD, MBA is Executive Medical Director of Clinical Operations for Brigham Health, in the Office of the Chief Medical Officer. Dr. Mendu is also a practicing nephrologist and Associate Medical Director of Mass General Brigham Population Health Management. She received her MD and MBA degrees from the Yale School of Medicine and Yale School of Management. During her internal medicine residency at Brigham and Women’s Hospital, she was involved in the Medicine Management Leadership Track and developed an interest in addressing system-level deficiencies in quality and care delivery by implementing innovative interventions. She pursued nephrology fellowship at Brigham and Women’s and Massachusetts General Hospital. Dr. Mendu’s administrative responsibilities are focused on care continuum management and inpatient operations. Her research efforts relate to care delivery innovation, quality and safety and population health. 

 

Glenda Roberts

Glenda is a passionate activist for kidney research and patients living with kidney disease. She’s involved in myriad patient-centered national and international health care transformation initiatives. All are focused on addressing patient preferences and improving patient-reported outcomes. Glenda brings the patient voice to a number of NIH/NIDDK government and industry research efforts, as well as, the ASN COVID-19 Response Team and the ASN COVID-19 Transplant Subcommittee. She’s a member of the ISN, the Kidney Health Initiative (KHI) Patient and Family Partnership Council (PFPC); Can-SOLVE CKD International Research Advisory Committee; Home Dialyzors United Advisory Board and she’s has been an Ambassador for the American Association of Kidney Patients since 2018.

 

Learn more about what this means for people living with kidney disease: https://www.kidney.org/newsletter/changes-to-egfr-calculation-and-what-means-people-living-kidney-disease 

BONUS: Coping with pediatric kidney disease

Nearly 10,000 children in the country are diagnosed with kidney failure and require either dialysis or a kidney transplant to stay alive. What does a pediatric kidney disease diagnosis look like for families and how can loved ones can offer their support? This bonus episode features a conversation from The Journey Continues, a podcast by the National Kidney Foundation of Illinois. Host and kidney transplant recipient Monica Fox spoke about pediatric kidney disease with Katie Adduci, a nurse and living kidney donor to her son Max, as well as Nicole duMont, a licensed social worker who has worked with children in all stages of kidney disease and transplantation.

Download and subscribe to "The Journey Continues" in Spotify, Stitcher, Apple Podcasts, Google Play, or wherever you like to listen.

Tips for overcoming financial hardship

Many kidney disease patients often face financial hardships, such as having to leave a job or struggling to pay for medications. Applying for or maintaining insurance may also be overwhelming and may create challenges with access to care. In today’s episode, physician and a postdoctoral research fellow Dr. Isaac Acquah talks about his recent research into the financial impact on people with chronic kidney disease with guests Beth Witten, a social worker, and Charles Pecoraro, a dialysis patient.

In this episode, you will hear from:

 

Dr. Isaac Acquah, MD, MPH

Dr. Isaac Acquah is a physician and a postdoctoral research fellow at the Center for Outcomes Research  at Houston Methodist Hospital. He holds an MD degree from the University of Ghana School of Medicine and Dentistry, and a Master of Public Health (MPH) degree from the Harvard T.H. Chan School of Public Health. He is particularly concerned about health care disparities and social determinants of health. Prior to moving to the United States, he practiced in both rural and urban settings where he directly experienced the influences of these determinants on a person’s health. His current work as a postdoctoral fellow involves understanding health care disparities among different patient populations and how they affect patient outcomes.

 

Beth Witten

Beth Witten is a renal social worker. She has worked with dialysis and transplant patients for over 40 years. She has been an NKF employee and volunteer and past chair of NKF's social work council. Beth ran CKD classes for many years. She consults with the nonprofit Medical Education Institute. Beth speaks and writes on choosing a treatment, paying for treatment, working and living your best life with kidney disease.  

 

Charles Pecoraro

Charles Pecoraro is a dialysis patient who is also currently on the transplant waitlist at Mayo Clinic in Florida.  In June 2019 he was diagnosed and treated for Malignant Melanoma Cancer.  In follow up visits with his PCP, they found he had high blood pressure.  He experienced debilitating emotional, mental, and physical symptoms from CKD that ultimately affected his ability to continue working and he lost the business he had owned for many years.  He also experienced delays in care due to insurance issues and ultimately started on dialysis emergently in March 2020. Charles is a kidney advocate with NKF. 

 

Resources mentioned in this episode:

• dol.gov (U.S. Department of Labor)
• ssa.gov/redbook or (800) 772-1213 (Social Security Disability Insurance)
• Healthcare.gov
• Medicare.gov
• Needymeds.org and mat.org (Medicine Assistance Tool)
• Benefits.gov
• Unitedway.org
• shiphelp.org or (877) 839-2675 (State Health Insurance Programs)
  
  

How to become an advocate for kidney health

Over the past year, NKF advocates have won a number of policy campaigns both in Congress and state capitals across the country. While these victories will improve the lives of kidney patients nationwide, we’re not done yet. We need every voice for kidney health to join the fight to ensure that we are heard across the country. In this episode, we discussed some recent wins and our upcoming challenges for the kidney advocate community with Jeff Currey, a Connecticut State Representative and kidney transplant recipient, and Armand Halter, an NKF patient advocate who helped lead NKF’s efforts to pass the Connecticut version of the Living Donor Protection Act.

 

In this episode, you will hear from:

 

CT Representative Jeff Currey:

Rep. Jeff Currey is a United States State Senator in Connecticut who who was re-elected to a fourth term in 2020 to serve the 11th Assembly District. Currey, who went public with his kidney failure prognosis in 2020, received a kidney transplant from a longtime friend in January 2021. In May he supported and advocate for the Living Donor Protection Act (HB 6387) in Connecticut, which prohibits insurers from discriminating against living organ donors and creates a committee to promote kidney donation in the state.

 

Armand Halter:

Armand Halter is a patient-advocate from Connecticut who has led NKF’s efforts to pass a state version of the Living Donor Protection Act (HB 6387) in Connecticut, including testifying on February 11th. He has also been a mentor to fellow advocates and helped organize Connecticut advocates in their efforts to pass bills and raise awareness in the state legislature.

 

For more information on NKF's advocacy efforts and how to become an advocate yourself, visit voices.kidney.org. You can also email us directly at advocacy@kidney.org.

BONUS: Systemic Lupus and Lupus Nephritis

This bonus episode features a conversation about lupus nephritis between rheumatologist Dr. Irene Blanco and Shanika Chuying, a person living with the disease. Lupus nephritis causes inflammation of the small blood vessels that filter waste in the kidneys and is one of the most common yet dangerous complications of lupus. Half of all Americans living with lupus will at some point develop lupus nephritis and up to 3 out of 10 people with lupus nephritis will develop kidney failure within 15 years of their diagnosis. Dr. Blanco and Shanika will discuss the facts about diagnosis and treatment of the disease as well as clear up some common misconceptions.

In this episode you will hear from Irene Blanco, M.D., M.S., a professor at the Albert Einstein College of Medicine and the Associate Dean for Office of Diversity Enhancement. She specializes in the treatment of people with autoimmune diseases, such as lupus. You will also hear from Shanika Chuying, a person living with lupus nephritis.

For more information on lupus and lupus nephritis, visit kidney.org/atoz/content/lupus. You can find a full transcript of the conversation at kidney.org/doctor-patient-dialogue.

 

Delta variant and COVID-19 booster shots

A major worry for many people right now is the Delta variant, a highly contagious strain of COVID-19 which is making headlines across the United States. The FDA has just authorized a third dose of the COVID-19 vaccine so that immune compromised patients can better protecting themselves from the virus. What does this mean for CKD, dialysis, and transplant patients? We spoke with Dr. Joseph Vassalotti, NKF Chief Medical Officer, in a recent Facebook Live to share the facts about the Delta variant, COVID-19 booster shots, and other concerns facing kidney patients.

 

In this episode, you will hear from:

Joseph A. Vassalotti, MD:

Nephrologist Joseph A. Vassalotti, MD, is the Chief Medical Officer of the National Kidney Foundation and Associate Clinical Professor of Medicine in the Division of Nephrology, at Icahn School of Medicine at Mount Sinai in New York, NY. He received his medical degree with Distinction in Research from the SUNY Stony Brook School of Medicine and completed an Internal Medicine Residency and Nephrology Fellowship at the Johns Hopkins Hospital. At NKF, his major focus is implementation of evidence-based clinical practice guidelines in chronic kidney disease (CKD), including the NKF’s Kidney Disease Outcomes Quality Initiative (KDOQI), particularly through guidance of the NKF’s primary care initiative, called CKDintercept. He has served as co-principal investigator for the U.S. Center for Disease Control and Prevention (CDC), demonstration project “CKD Health Evaluation and Risk Information Sharing” (CHERISH), which aimed to identify individuals at high risk for kidney disease in the U.S. and as an investigator for the U.S. National Institutes of Health (NIH) sponsored clustered practice randomized trial entitled, “Evidenced-Based Primary Care for Kidney Disease.”

 

For more resources on COVID-19 for kidney patients, visit www.kidney.org/coronavirus

Plant-based diets: Can they work for kidney patients?

Today’s hot topic is plant-based diets. For some kidney patients, eating more plant-based foods may help prevent and slow the progression of chronic kidney disease. But what exactly does a plant-based diet entail and how do you know if this diet is right for you?

In this episode, you will hear from:

 

Brittany Sparks, RDN, CSR:

Brittany Sparks is a registered dietician and board-certified specialist in renal nutrition. Her private practice focuses heavily in helping those with chronic kidney disease. She provides evidenced based medical nutrition therapy and enjoys speaking nationally on nutrition-related topics. She also creates recipes and teaches how to follow through with nutrition recommendations in the kitchen.

 

Eric Singer:

Eric Singer was diagnosed with focal segmental glomerulosclerosis (FSGS) in 2007 and currently advocates for whole food, plant-based diets.

 

Additional resources:

Finding a dietitian - https://bit.ly/378LNtG

Finding a dietitian - https://bit.ly/3xcfa8Q

KDOQI guidelines: https://bit.ly/3rIxxRC

Plant-based Recipes: https://bit.ly/3ycxNLt

More plant-based info: https://bit.ly/3BUr8aP

Creating an inclusive and affirming environment for LGBTQ+ kidney patients

For many in the LGBTQ+ community, fear of discrimination and harassment can get in the way of seeking medical care when they are sick and can put them at increased risk of serious health problems, including kidney disease. In this episode, we discussed how to create an inclusive and affirming environment in a healthcare setting with Dr. Dinushika Mohottige and Dr. Mitchell R. Lunn, two experts in sexual and gender minority health, as well as living kidney donor and the first openly gay elected state legislator in Pennsylvania history, Rep. Brian Sims.

In this episode, you will hear from:

 

Dinushika Mohottige, MD, MPH:

Dr. Mohottige is a Nephrologist and Medical Instructor in the Division of Nephrology at Duke University Hospitals. She received a B.A. in Public Policy and a Health Policy Certificate from Duke University in 2006, where she was a Robertson Scholar. She then earned an MPH in Health Behavior/Health Education from the UNC Gillings School of Global Public Health and a medical degree from the University of North Carolina at Chapel Hill School of Medicine, followed by Internal Medicine and Nephrology training at Duke University. She now works under the mentorship of Dr. Ebony Boulware and Dr. Clarissa Diamantidis to engage in patient and community-centered, inequity-focused research around the impact of socio-structural factors on kidney health and kidney transplantation.

 

Mitchell R. Lunn, MD, MAS, FACP, FASN:

Dr. Lunn is an Assistant Professor in the Division of Nephrology of the Department of Medicine at Stanford University School of Medicine. As an internist and nephrologist with a strong interest in technology and sexual and gender minority health, Mitch’s research is designed to characterize the health and well-being of these populations. Mitch is the co-director of PRIDEnet, a participant-powered research network of SGM people that engages SGM communities at all stages of the biomedical research process: research question generation and prioritization, study design, recruitment, participation, data analysis, and results dissemination. He currently serves on the American Society of Nephrology’s Diversity and Inclusion Committee.

 

PA State Representative Brian Sims:

Brian Sims is a member of the Pennsylvania House of Representatives in the 182nd district. Elected in 2012, Sims is also a lawyer and activist on LGBTQ+ civil rights. Sims is the first openly gay elected state legislator in Pennsylvania history. In January of 2020, he donated his kidney to his friend. He has been vocal about supporting organ and tissue donation. Currently, he is a candidate for Lieutenant Governor of Pennsylvania in the 2022 election.

 

What the new CDC masking guidance means for kidney patients

The CDC's new masking guidance says fully vaccinated people do not have to wear masks, but does that include kidney patients? Are people who are immune comprised fully protected by the vaccine? We have collected some of our patients’ most pressing questions about the new masking guidance and have asked Dr. Joe Vassalotti, NKF Chief Medical Officer, to answer them.

We answer the following questions:

1. Is it safe to get the COVID-19 vaccine if you have kidney disease?
2. Should I go to the doctor to determine if I have developed antibodies from the COVID-19 vaccine?
3. If I don’t develop antibodies after getting the COVID-19 vaccine, should I get another one?
4. I am a transplant recipient. Will the vaccine protect me if I get COVID-19, even if it’s only 50% effective?
5. I am a dialysis recipient. Will the vaccine protect me if I get COVID-19, even if it’s only 50% effective?
6. I’m a transplant patient. Does my family need to continue wearing a mask around me and others?
7. Is it safe for a transplant or dialysis patient to work in an office without a mask with a coworker who is not vaccinated and won’t wear a mask?
8. I am immunosuppressed and vaccinated, but my grandson is not. Should I continue wearing a mask around him?
9. Is it safe for fully vaccinated family members to be around transplant and dialysis patients without a mask?
10. If someone already had COVID-19 do they need two doses of the vaccine?
11. If a transplant or dialysis patient did not get second shot in time, can they start the process over?
12. Did the new masking guidelines from the CDC create a false sense of security?
13. What should kidney patients do if they get COVID-19?

 

In this episode, you will hear from:

Joseph A. Vassalotti, MD:

Nephrologist Joseph A. Vassalotti, MD, is the Chief Medical Officer of the National Kidney Foundation and Associate Clinical Professor of Medicine in the Division of Nephrology, at Icahn School of Medicine at Mount Sinai in New York, NY. He received his medical degree with Distinction in Research from the SUNY Stony Brook School of Medicine and completed an Internal Medicine Residency and Nephrology Fellowship at the Johns Hopkins Hospital. At NKF, his major focus is implementation of evidence-based clinical practice guidelines in chronic kidney disease (CKD), including the NKF’s Kidney Disease Outcomes Quality Initiative (KDOQI), particularly through guidance of the NKF’s primary care initiative, called CKDintercept. He has served as co-principal investigator for the U.S. Center for Disease Control and Prevention (CDC), demonstration project “CKD Health Evaluation and Risk Information Sharing” (CHERISH), which aimed to identify individuals at high risk for kidney disease in the U.S. and as an investigator for the U.S. National Institutes of Health (NIH) sponsored clustered practice randomized trial entitled, “Evidenced-Based Primary Care for Kidney Disease.”

 

For more resources on COVID-19 for kidney patients, visit www.kidney.org/coronavirus

 

Coping with depression & anxiety during a global pandemic

Depression and anxiety affect many Americans but they are especially common in those with chronic illness like kidney disease. How has depression and/or anxiety affected you during your journey with kidney disease? We spoke with Tracey Doss-Simmons, LMSW, an outpatient social worker at a dialysis center in Michigan, and two dialysis patients, Ellyne and Sean, to get their insight.

New way to get involved in research

In this episode, we talk about the NKF Patient Network, an online registry for kidney patients at any stage of kidney disease. This network is an exciting new and easy way to for patients to be part of the effort to improve the lives of people affected by kidney disease everywhere. 

 

In this episode, you will hear from:

 

Dr. Kerry Willis:

Dr. Kerry Willis is Chief Scientific Officer at the National Kidney Foundation and co-developer of the Patient Network. Dr. Willis received her PhD in Molecular Genetics from New York University Medical Center and has been with NKF since 1998. She founded NKF's Medical Activities division and made it a priority to identify and apply the best science available to improve kidney disease patient care and outcomes.

 

Dr. Lesley Inker:

Lesley A. Inker, MD, MS is a nephrologist who serves as Director of the Kidney and Blood Pressure Center and Director of the Kidney Function and Evaluation Center at Tufts Medical Center. She is also chair of the NKF Patient Network Steering Committee. Dr. Inker’s research has established her as an expert in the implementation of estimated glomerular filtration rate by clinical laboratories, as well as an expert in estimating and measuring kidney function.

 

Dr. Alex Chang:

Dr. Alexander Chang is a nephrologist, assistant professor of Clinical Research and co-director of the Kidney Health Research Institute at Geisinger. He is engaged in research dedicated to preventing and delaying CKD progression and its complications. His research areas include interventional studies focused on improving lifestyle behaviors in patients with hypertension and patients with early CKD; using observational data from Geisinger and other large cohorts to identify potential avenues to improve management of CKD and hypertension; and health system interventions to improve early recognition and optimized management of early kidney disease. Dr. Alex Chang also serves as NKF Patient Network PI for Geisinger site.

 

Curtis Warfield:

Curtis Warfield is a kidney patient and patient stakeholder on the Patient Network Advisory Committee. In 2012 he was diagnosed with Stage 3 Chronic Kidney Disease (CKD) due to FSGS. In 2016, he received a kidney from his daughter’s college sorority sister. Curtis, a passionate advocate for CKD, organ donation and living donors provides peer counseling with the NKF Peer Program. He also serves as member of NKF’s Kidney Advocacy Committee, where he advocates with members of Congress for kidney and organ donor issues.

 

Cari Maxwell:

Cari Maxwell is a kidney patient and patient stakeholder on the Patient Network Advisory Committee.  She was diagnosed with Autosomal Dominant Polycystic Kidney Disease in 1989 and has been an active supporter of the National Kidney Foundation. She hopes that through her commitment to the awareness of chronic kidney diseases, others will take an active role in their health journey through early detection, healthy choices, and becoming a strong voice themselves in advocating for those that cannot.

 

Learn more about the NKF Patient Network by visiting www.kidney.org/nkfpatientnetwork.

Is mobile health the way of the future?

In the COVID era, telehealth has become a suddenly normal part of our lives. How is this impacting kidney patients and what implications does it have for the future of kidney care? We sat down with researcher Dr. Sarah Schrauben to discuss her recently published article on Mobile Health Technology in NKF’s American Journal of Kidney Disease (AJKD).

 

In this episode, you will hear from:

 

Dr. Sarah Schrauben:

Dr. Schrauben is a researcher and Assistant Professor of Medicine and Epidemiology in the Division of Renal, Electrolyte, and Hypertension, and Department of Biostatistics, Epidemiology, and Informatics at the Perelman School of Medicine. Dr. Schrauben's research focuses on the impact of health behaviors and modifiable risk factors in the development and management of chronic kidney disease and its complications, as well as addressing implementation gaps of evidence-based care in CKD.

 

The episode is moderated by NKF patient advocate Jessica Washington. Jessica was diagnosed with stage 2 kidney disease in 2019. She has been extremely motivated to advocate for the National Kidney Foundation to help others fight for better understanding, awareness, support, and anything else she can do to make it easier for so many out there dealing with this disease.

 

Learn more about Dr. Schrauben’s research by visiting www.kidney.org/newsletter/are-mobile-apps-wave-future-kidney-care.

The latest in COVID-19 vaccines for kidney patients

Many people are facing pandemic fatigue, but thanks to the COVID-19 vaccine the "new normal" may be right around the corner. We sat down during a recent Facebook Live event to answer patient questions about the vaccine and pandemic fatigue. 

 

In this episode, you will hear from:

 

Dr. Frita Fisher:
Dr. Frita is the founder and president of her own nephrology practice (Midtown Atlanta Nephrology, P.C.), and the medical director of a non-profit dialysis unit.  She now spreads her medical knowledge as a medical expert commentator, and has appeared as a medical expert on shows such as 11 Alive News NBC, the Emmy Award Winning Paternity Court, and others. Her YouTube channel (Dr. Frita) has over 270,000 subscribers. 

 

Gary Petingola, MSW, RSW:

Gary has received formal training with Dr. Jon Kabat- Zinn, founder of The Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School; the Centre for Mindfulness Ireland; the OMEGA Institute for Holistic Studies; Shambhala Mountain Center; the Harvard Medical School; and the Community for Mindful Living. Gary has recently published his first book titled The Response – Practicing Mindfulness In Your Daily Life. 

 

For more information on the COVID-19 vaccines for kidney patients, visit www.kidney.org/coronavirus/vaccines-kidney-disease