Managing Chronic Kidney Disease: Life Saving Steps Learned From Native Americans

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Managing Chronic Kidney Disease: Life Saving Steps Learned From Native Americans

By Thanh Tran, CEO, Zoeticx and Donald Voltz, MD, Aultman Hospital, Medical Director of the Main Operating Room and EMR Industry Advisors

For years, hypertension has dominated the healthcare field, afflicting 45 percent of all adult Americans, inducing a number of lethal complications in patients across the country. Another disease that has gained renown in the world of healthcare is diabetes,afflicting 10.5 percent of the U.S. population with its own complications.
Healthcare professionals have allocated untold assets in the form of time, money, and personnel to minimize the impact such diseases pose yet the relative obscurity and lack of funding towards combatting Chronic Kidney Disease (CKD) is ironic, considering its impact on the world’s population.
A notable example of a resounding success in CKD management was found in the Indian Health System’s (IHS) novel strategy on CKD surveillance and treatment. American Indians and Alaska Natives (AIAN) had a whopping 57.3 percent incidence rate for diabetes related ESRD ...
... in 1996. In 2013, that value was cut in half, lowering down to a mere 26.5 percent in 2013. This drastic change corresponded with the IHS’ bold strategy where they opted to take proactive steps in identifying and treating CKD in early stages.

The CMS study noted three major steps undertaken by IHS that had a significant effect on patient outcomes. These steps were:
• CKD identification
• Treatment and monitoring of CKD progression
• Patient-centered care approach.

During the COVID-19 pandemic’s worst outbreak, the American Indians and Alaska Native (AIAN) community, like so many others, haveadopted lockdown procedures to slow the spread of the disease. Though many may argue the efficacy of the lockdowns themselves, a question very few dares ask is how the lockdowns affected other conditions.

Due to local legislature advising residents to stay at home, there have been numerous recorded incidents of weight gain across the country, a phenomenon known as “Covibesity”. With obesity being a major risk factor for both diabetes and hypertension, it would be prudent to enact the IHS’ novel strategy on CKD management on a wider scale.

Applying the IHS Model

Though the IHS’ strategy at combatting CKD is a model that all other healthcare systems should aspire to,additional changes are required to apply it. One scalable change is the fact that the IHS’ model only targets CKD for patients with diabetes. Its policy of testing all diabetes patients for CKD on a regular basis would be economically impossible due to the sheer number of patients and tests.