Understanding Chronic Kidney Disease

Not long ago, our first guest was quite literally fighting for his life. But he’s here today
because he’s a passionate advocate for kidney disease awareness, and he’s hoping his story
may be able to possibly help you or your loved one. He’s also joined by an equally dedicated
kidney disease expert. Joining me this morning are David White and Dr. Tushar Vachharajani.
Good morning, gentlemen. Thank you so much for being here.
Good morning. Delighted to be here. Doctor, let me start with you. Let’s talk
about kidney disease and the magnitude of it today in America.
It’s a huge problem. There are about 26 million Americans who have kidney disease.
That many? Yes. That many. And roughly one in three American
adults are at risk of having a kidney problem. Plus, it adds to the cost for health care
because of such a huge problem that is not recognized easily. And roughly 80 billion,
and that’s with a “B”, 80 billion costs for treating patients with chronic kidney disease.
And you know when I hear about silent killers, you know, we think about heart disease, we
think about ovarian cancer, and I was reading here that this disease is known also as a
silent killer. Absolutely. It is a silent killer because
the patients don’t get symptoms until it’s pretty late in the game. And by the time it
presents, they have serious serious problems that they have to worry about surviving rather
than trying to find the cure for it. And who’s at risk, Doctor, for this?
By and large, diabetes and high blood pressure. These are the two main risk factors. There
are other additional risk factors like age. Anybody over the age of 60. And patients who
are obese, patients who have smoking habits, or patients who have bad lifestyle. They are
really at risk of developing chronic kidney disease.
And David, if I can bring you in, and thank you so much for being here and sharing your
story with us. What stage of kidney disease are you at and how do you manage this illness?
I’m currently at stage 3. And that means what?
That means that my kidneys are functioning okay. At the moment, I should say kidney because
I was transplanted last summer. Okay.
That means my kidney is functioning okay, but it needs constant monitoring just to make
sure that it doesn’t get worse. Because if it does, I’m in real trouble. There are five
stages of kidney disease. Stage 5 is the worst, that’s called end-stage renal disease or kidney
failure. That’s what I was diagnosed with in 2009.
Oh my gosh. I had what’s called “a crash”, so I had to
go to the hospital. I was in the hospital for 3 weeks. During that time, I actually
stopped producing urine and I had to have surgery to have a catheter placed so I could
start dialysis immediately. And would you say, David, that one of the
biggest issues and the most important issue is that of dialysis?
Well, I think most people with kidney disease would say the most important issue is staying
alive. Staying alive.
Dialysis is how most of us do that. There is another option and that’s a kidney transplant.
That’s the preferred option. And Doctor, would you agree that sometimes,
like you just said, it’s sometimes a little bit too late in the game, and then the situation
can get more grave? Yes, absolutely. I mean, patients who don’t
get diagnosed until the late stage, we call them “crash landers.” So when they come in,
for them, survival becomes a major issue and getting them back on their feet is more important
than trying to get the solution to what can be done to help them out eventually.
And the consequences then of that late stage and that late in the game like you just said,
and then the catheter, and dialysis for the patient?
Yes, when they are that late in the game, the only way to provide dialysis is with the
help of a catheter, and then catheter brings in its own set of problems and risks and risk
of infection. Which is important then to note that it’s
better not to get there and to kind of plan and try to get there before that occurs.
Absolutely. Planning and knowing and being aware of what the problem is is more important
to get to the ultimate treatment. And that’s why we’re going to talk a little
bit more about it. So stay right there gentlemen because when we come back, we’re going to
learn about a comprehensibly better way to manage late stage kidney disease, and here’s
a hint. It has the do with avoiding denial, which is so important, and planning ahead.
So stay with us. (music).
(music). Welcome back, everyone. We’re observing National
Kidney Month with two very special guests, kidney dialysis patient and advocate, David
White, and also renowned Nephrologist, Dr. Tushar Vacharajani. Doctor, let me start with
you. Planning. Huge, right? Absolutely.
What is the first step to start planning dialysis? When you start thinking about dialysis, educating
the patient is the most important thing. Educating the patient about different modalities of
dialysis and then planning for a dialysis access such as a fistula which is the best
option to have planned well in advance so that when the patient really needs to start
dialysis, the patient is ready both mentally and physically.
Can you tell me quickly what a fistula is? A fistula is where a surgeon creates a hook-up
between two blood vessels in the arm. That’s the best place to have it. It’s under the
skin, it’s a small procedure, generally takes about a day’s stay in the hospital.
And David, in your situation, did you use one? Did you have that option or were you
using a catheter? I was using a catheter because I didn’t have
a choice. I didn’t have a choice because I didn’t know that I had kidney disease because
I showed no symptoms. And that’s where the key here is to know the
symptoms and plan ahead, right Doctor? Yes. Being aware of it, and follow up with
regularly with your physicians, and follow up with regular blood tests so you know way
in advance that you’re going to need dialysis, and you can have plans put in place.
And Doctor, are most dialysis patients today using fistulas because of the awareness, if
you will? Unfortunately not.
No, hmm. The sad story is that almost 80%, almost 4
out of 5 patients, start dialysis with a catheter. Really?
Yes, and that’s a disaster because catheter has its own problem. The tip of the catheter
is situated in the heart, so if there is an infection, the infection can spread all over
the body pretty quickly. As opposed to the option of the fistula which
is more beneficial because… Because it is under the skin, there is no
plastic hardware, and it’s definitely not directly in connection with the heart.
And David, as someone who’s been through this now and knows that kind of option, I’m sure
it would have made a difference for you. It sure would have. Living with kidney disease
and dialysis is hard. Living through it with a catheter is even worse because it’s uncomfortable
and it can be a mental burden as well. And that’s why you’re here today sharing your
story. And I know you brought me this beautiful green rubber bracelet. I love it. I’d like
to share with my viewers what it says. It says, “Hope, Love, Faith”. I’m also wearing
the pin. I know this means a lot to you. You’re very passionate about creating awareness and
educating others out there to do what really is the best thing for them.
Yes. That’s why the pin is green, as I’m dressed in green, and this green is the color for
kidney disease awareness, and this is Kidney Disease Awareness Month. And we just want
everyone to know that kidney disease is not a death sentence. It is challenging, but I
am living proof that you can work with it and have a positive result.
Doctor, would you like to chime in? Yes. I echo what David just said and it is
not the end of the world. There are options, and if you are aware of it, we can treat in
a much better way and find solutions to get you back on your feet and get you back to
doing what you like to do. And Doctor, for our viewers out there who’d
like more information on kidney disease and what to look out for and options like fistula,
where do they go? Well, there are two very good websites. One
is kidney.org. The other one is AAKP.org. And again, you can always ask for help in
your doctor’s office. There are enough people around who can definitely provide you with
information in a simple format that you can understand.
Thank you for the information. Thank you very much.
Appreciate your time. And of course, you can always logon to our website, that’s TheBalancingAct.com.
Again, the websites are kidney.org or AAKP.org for more information about kidney disease.
And remember, National Kidney Awareness Month. (music).

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