Summertime in the Pacific Northwest is a great time to catch a glimpse of salmon making the life and death journey swimming upstream back to the place of their birth.
We often talk about working “upstream” with patients with kidney failure and how critically important, yet difficult, this work can be. One out of seven Americans (30 million!) has chronic kidney disease (CKD), often referred to as the “silent killer,” due to symptoms that are undetectable until it is too late. Not only is CKD a growing public health threat, but the health care costs associated with CKD and end stage renal disease (ESRD) represent more than a quarter of all Centers for Medicare & Medicaid Services (CMS) claims.
Nephrologists who care for kidney patients have increasingly expressed their concern for the lack of care for patients in the early stages of ESRD (stage 1-4) before kidney failure (stage 5). Dr. Louis Cotterell, a nephrologist and member of the ESRD Network board of directors, relayed the importance of working “upstream”, he said: