Championing For Total Health
Chronic Kidney Disease: An Overview
CKD is a progressive loss of kidney function, beginning asymptomatically and potentially progressing to near complete kidney failure – End Stage Renal Disease (ESRD) – requiring dialysis or transplantation; while most individuals do not progress to kidney failure.
37 million Americans are estimated to have CKD, 90 percent who are unaware of their condition.
Nearly 25% of beneficiaries in Medicare FFS were diagnosed (2018 data), a number that is increasing.
Causes include injury, infection or a genetic condition; lupus, diabetes, and hypertension are major factors.
Controlling risk factors for CKD, screening, and medications are important components of CKD prevention and management.
Screening includes measuring protein in the urine and calculating GFR.
Interventions targeting specific symptoms, or aimed at supporting educational or lifestyle considerations, can make a positive difference to people with CKD.
Your primary care team, diabetes educator, and social worker can help prevent, screen for, provide education and treatment; a nephrology specialist provides advanced care.
Chronic Kidney Disease Resources
Chronic Kidney Disease and People of Color
Chronic kidney disease reveals many racial and ethnic disparities. People of color are:
- More likely to develop CKD
- 16 % of Black adults, 14% Hispanic adults, and 13% of white adults are estimated to have CKD
- 33% of Black Medicare FFS beneficiaries have CKD versus 23% of white beneficiaries
- Less likely to receive recommended care related to CKD risk factors
- For every white person who develops ESKD, 3 Black people develop ESKD
- For every 3 non-Hispanic people who develop ESKD, 4 Hispanic people develop ESKD
- Less likely to reduce CKD risk by achieving recommended treatment goals for blood pressure, diabetes, and cholesterol control
- More likely to progress from CKD to ESRD
- Present with kidney failure at younger ages
- Less likely to have been under the care of a nephrologist before starting dialysis
- Present with kidney failure at younger ages
- Less likely to have been under the care of a nephrologist before starting dialysis
- Experiencing increased delays for kidney transplantation
- Median wait time is longer for Black patients (59.9 months) than for white patients (41.3 months)
- Median wait time is longer for Hispanic or Latino patients (55.8 months) than for non-Hispanic patients (47.4 months)
- Multiple factors contribute to CKD racial and ethnic disparities including: lack of access to primary and specialty care; mistrust of the health system; lack of knowledge about CKD; increased levels of risk factors; lack of access or resources to obtain healthy food; provider knowledge and implementation of quality care; patient health literacy; provider and system engagement with communities of color; systemic racism
Chronic Kidney Disease and People of Color: Resources
Chronic Kidney Disease and Vaccines
People with chronic kidney disease have a higher risk of complications due to vaccine-preventable illnesses such as flu and COVID-19.
A person suffering from chronic kidney disease is more likely to experience chronic dry cough and fatigue as a result from COVID-19. And job related disabilities due to other illnesses.
In addition to getting vaccinated, it’s important to protect yourself by taking other precautions such as wearing a mask, washing hands, social distancing, opt for outdoor events to keep yourself protected from COVID-19 and other illnesses when you have Chronic Kidney Disease.
Chronic Kidney Disease and Vaccines: Transplantation
People who have received a kidney transplant should receive age-appropriate inactivated vaccinations as recommended for general population.
But people with a kidney transplant should not receive live vaccines.
It is best to wait until 3–6 months after a kidney transplantation, when immunosuppression is especially intense, before getting a vaccine.
Family members, care-takers, household contacts and health care providers involved with people who have received a transplant should all be vaccinated.
Chronic Kidney Disease and Vaccines: The Flu Vaccine
People at all stages of CKD, including those who have received a transplant or are undergoing dialysis, are at high risk of developing serious flu complications due to weakened immune response.
Annual flu vaccination is recommended to prevent serious illness. Injectable flu shots – NOT THE NASAL SPRAY – are recommended for use in people with CKD
Flu vaccination is associated with lower rates of hospitalization due to pneumonia/influenza and heart disease, especially in more advanced disease.
For more information you can check our Health Champions or SHC resources.
Chronic Kidney Disease and Vaccines: COVID-19
CKD increases the likelihood of getting very sick from COVID-19.
- It’s now thought that CKD is the most common risk factor for severe COVID-19 worldwide.
- A recent study found that people with COVID-19 and ESRD were 11 times more likely to be hospitalized than people who didn’t have kidney disease.
- People of color have added risk.
- A significant number of patients who survive COVID-19 need renal replacement therapy after leaving the intensive care unit.
It is important to continue with regularly scheduled dialysis treatments and take necessary precautions as recommended by health care providers.
If COVID-19 infection is suspected, get tested and, if positive, contact their kidney healthcare provider.
People with a kidney transplant should keep taking anti-rejection medicines.
CKD patients should receive the COVID vaccine.
- Currently, a total of four doses are recommended preferably with an mRNA COVID-19 vaccine – the Pfizer and Moderna vaccines.
Whenever possible, COVID-19 vaccines should be administered at least 2 weeks before initiation or resumption of immunosuppressive therapies.
In addition to vaccination, continue to take precautions, including: wearing a mask, social distancing, limit close contact, wash your hands often, avoid crowds and during an outbreak stay home as much as possible.
It is important for family and household members and care-givers to be fully vaccinated and otherwise minimize exposure.
Stay up-to-date by talking with your healthcare team and follow updates from the CDC and kidney.org.
Chronic Kidney Disease and Vaccines: Resources
Chronic Kidney Disease – The Patient and Caregiver Perspective
If you or someone you love is going suffering with Chronic Kidney Disease, you are not alone.
Creating a community of uplifting support is key when managing a chronic illness and living a healthy life.
Watch Dietta’s story from the National Kidney Foundation of Michigan for some inspiration and support.
Resources of Chronic Kidney Disease Patients and Caregivers
Watch Now: Kidney Disease, Health and You
NMQF”s Center for Sustainable Health Care Quality and Equity and the National Kidney Foundation of Michigan for a Health Champion discussion from the eyes of Chronic Kidney Disease experts and a patient voice.
Health Champion webinars occur on the last Friday of each month. Be sure to subscribe to the Health Champions newsletter for details.
Panelists:
Yabo Beysolow, MD COVID and Flu Immunization Vaccine Expert AIM and iREACH Program for CDC
Laura Lee Hall, PhD President, Center for Sustainable Health Care Quality and Equity National Minority Quality Forum
Cynthia Nichols-Jackson Patient and Program Coordinator National Kidney Foundation of Michigan
Silas Norman, MD, MPH Associate Professor, Nephrology University of Michigan
Kristen Stevens Hobbs, MPH, CPH Senior Project Manager of Quality Improvement and Equity, Center for Sustainable Health Care Quality and Equity National Minority Quality Forum (Moderator)
