Lesson 1:
Kidney Disease Basics

What do you hope to get out of this session?

Have everyone to stand up. State the following: Please sit down when you can say yes to any of these questions: Do you know someone who has diabetes? High blood pressure? CVD? Kidney disease? By the end, most everyone will be sitting. Use this as an opportunity to explain that they are not alone.

• Emotional impact of diagnosis
  • You're not alone
  • Emotional aspects
  • Depression, grief and fear are typical
  • Physical activity may help
• Benefits of education: Why are you here?
• There are many causes of CKD. Diabetes and hypertension are the leading causes. Family history, cardiovascular disease, recurrent UTIs, immunological disease and genetics also play a role in CKD
• CKD is complicated
• The more you understand,the better you'll do.(State directly)
• Basic anatomy
  • Location in the body
  • The nephrons have filters (working units)
• Normal kidney function
  • Maintain chemical balance
  • Produce hormones
  • Regulate blood pressure
• Kidney damage
  • Major causes of kidney damage
  • High blood pressure, diabetes
    • Fewer functioning nephrons
• Monitoring kidney function and damage
  • eGFR (function)
  • Urine albumin/UACR (damage)
• eGFR goal: a stable level
  • Decline means progression
• Urine albumin/UACR goal: a stable or lower level
  • Increase in urine albumin may mean progression
• Kidney disease is often irreversible and progressive
  • You'll likely need the help of a kidney specialist (State directly)
  • Overview of treatment modalities
• There are things you can do that may slow progression (more on this in next session)
  • Take your medications
  • Control blood pressure
  • Manage diabetes
  • Eat less salt

Miscellaneous

• Kidney disease runs in families (Encourage testing)
• Early kidney disease has no symptoms

• The Kidneys and How They Work (NIDDK)
  • What do the kidneys do?
• For People with Diabetes or High Blood Pressure: Get Checked for Kidney Disease (NKDEP)
  • Graphic and text
  • Why should I be checked for kidney disease? (NKDEP)
• How Well Are Your Kidneys Working: Explaining Your Kidney Test Results (NKDEP)
  • How well are your kidneys working? (NKDEP)
• CKD: What Does it Mean for Me? (NKDEP)
• Physical Activity and Weight Control (WIN)

• Assessment, Management and Treatment (AMT) (NKDEP)
• CKD Information for Health Professionals (NKDEP)
• NKDEP videos:
  • What do the kidneys do?
  • What is CKD?
  • How do you check for kidney disease?
  • Can kidney disease get better?
  • Will I need dialysis?
• The kidneys and how they work (NIDDK, 2/09)
• Educating Patients about CKD (NKDEP)
• Questions and answers about kidneys and kidney disease (family history)
• Glomerular Disease Primer: (NIDDK, 1/09)
• Kidney Failure Glossary (NIDDK, 4/03)

• What are two ways that the kidneys help keep you healthy?
• What two tests should be used to check your kidneys?

Other outcomes:

• Patient reports at least one causes of kidney disease, including that high blood pressure and diabetes are the two major risk factors.
• Patient reports that he/she knows it is normal to feel afraid or sad about having KD.
• Patient states or lists two ways the kidneys help maintain health.
• Patient knows his/her numbers and what they mean.
  • a certain level of albumin in the urine means the kidneys are damaged
  • eGFR result indicates level of kidney function
• Patient states one way to slow progression of kidney disease.

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