Lesson 1: Understanding Kidney Disease

The content of this lesson, Understanding Kidney Disease, meets the needs of qualified providers seeking to deliver the Kidney Disease Education (KDE) Services benefit, as defined by the Centers for Medicare & Medicaid Services (beneficiaries must have an eGFR of 29 or lower).

Lesson Objectives

By the end of each session, participants will be able to:

• Recognize that fear and grief are usual responses to kidney disease
• State causes/risk factors for kidney disease
• Explain how GFR reflects kidney function
• Explain how urine albumin reflects kidney damage
• State two ways the kidneys help maintain health
• Describe how kidney disease is progressive but can be slowed down

Session Starter

What do you hope to get out of this session?

Have everyone 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.

Topics & Points to Cover

• 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

Materials/Content for Learners

• The Kidneys and How They Work
• How Well Are Your Kidneys Working: Explaining Your Kidney Test Results (PDF, 244.53 KB)
• CKD: What Does it Mean for Me?
• Is My Child At Risk for Kidney Disease?
• Health Tips for Adults

Background/Clinical Information for Educators

• NIDDK 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?
• Educating Patients about CKD (PDF, 244.53 KB)  

Sample Outcome Assessment Questions

• 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.

Additional Resources for Download

These images are available free of charge to download and include in your patient education materials.