Welcome! My guest today is Dr. Jeffrey Berns, who is the president of the National Kidney Foundation. He is a professor of Medicine and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Dr. Burns is the Associate Chief of the Renal, Electrolyte, and Hypertension Division and the Director of the Nephrology Fellowship Training Program and the Associate Dean for Graduate Medical Education.
Dr. Berns addresses the following aspects of kidney disease and its risks:

What is the National Kidney Foundation (NKF), its mission, and your role? The central office is in NY, but there are offices around the country, each manned by a wonderful staff. Dr. Berns’ role is to talk about the NKF, kidney disease and be a spokesperson and advisor to the board. The mission of the NKF is to help those with chronic kidney disease (CKD) identify the diseases. About 80% of kidney function can actually be lost to CKD with no noticeable symptoms! The NKF also focuses on education about CKD, risk factors, and causes, and research to identify treatments and cures.
What are the most common risk factors for CKD? One out of three adults is at risk, and up to 10% may already have CKD but be unaware of it. The most common causes are high blood pressure and diabetes; these diseases cause over 60% of all CKD that requires dialysis or transplant. Family history is a risk factor, as well as minority ethnicity and being over age 60. The ethnicity risk is tied to some socioeconomic factors and some genetic markers that seem to predispose African-Americans to CKD. Kidney disease is an important disease and is under-recognized in the US.
For patients with hypertension or diabetes, what tests can be done to screen for kidney disease? The most common tests are a blood test called a Serum Creatinine Level to test kidney function and a urine test to detect protein in the urine. Simply assessing urine output is not an accurate indicator.
Are urinary tract infections (UTI’s) a determinant in CKD? These infections are not really a risk factor, but recurrent kidney stones and kidney infections may be precursors to CKD.
How would someone know if they have CKD? Blood and urine tests are the only way to detect the disease until symptoms advance to a very serious stage. Discolored urine and swelling of the feet and ankles may be symptoms. The blood and urine tests are most commonly done at the ER and doctors’ offices in conjunction with other exams and other issues.
What kinds of resources are available through the NKF? Visit their website at www.kidney.org. You will find information there about the prevention of kidney disease as well as information about kidney function, tests, organ donation, and transplantation. NKF Cares is the patient information Helpline, available in English and Spanish. The website also includes a Peer Support program for patients, information about insurance, and My Food Coach, which has nutritional guidelines.
How does Medicare coverage factor into CKD? Those over age 65 are already at higher risk for kidney disease, and Medicare is the primary payer for those patients. A co-pay of 20% is required unless you have co-insurance, and most services are covered under Medicare Part B. For people under 65, coverage is a little trickier. After 30 months, Medicare becomes the primary provider for those on dialysis, but the rules vary according to the type of dialysis that people require. Medicare coverage kicks in immediately for transplant patients, but only lasts three years. The NKF is working to change those coverage limits.
For kidney donors, are exact matches required? Kidneys are matched with compatible blood types. An identical sibling is an ideal match, but any living donor is preferred over a deceased donor. Family members, friends and co-workers can be donors.
How good is the function of only one kidney if you’ve become a donor? Potential donors are extensively screened to assure a very low risk for future kidney disease