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an independent supplement by mediaplanet to usa today

aaron mcCargo shad ireland

bold flavors for defying the
restricted diets odds on dialysis

KiDnEY hEaLth
april 2011

3 tiPS

Denise Richards inspires and educates
photo: startraksphoto.coM

others about kidney cancer after losing

her mother to this deadly disease

No one is immune to the risk of venous needle dislodgement.

It can happen at any facility, to any nurse or patient.
(J. Hurst, RN, CLNC)
(J. Hurst, RN, CLNC)

Redsense Medical Inc.

Redsense is an FDA cleared device to monitor for blood loss from the hemodialysis Chicago, IL 60601, US
access site. To be used as directed by a physician. www.redsensemedical.com
2 · april 2011 an independent supplement by mediaplanet to usa today


Understanding the kidneys’ major role in overall health, knowing risk

factors for these conditions and taking the time to get screened
can make a difference in the lives and health of thousands.
Get SCReeNeD

protect your kidney health,

3rd edition, april 2011
managing Director: Jon silverman

kidneys: it’s vital

editorial manager: Jackie mcdermott
responsible for this issue:
Publisher: megan brunhofer
Business Developer:
luciana Colapinto

Designer: mariel Fitzgerald
olores Bisagni suf- lates blood pressure. Dr. lynda
radiation and chemotherapy. Contributors: michelle dalton,
fered from high Chronic kidney disease (CKD) Szczech It is serious, but the earlier it is Fresenius medical Care north america,
president, Kidney Cancer association, medical
blood pressure occurs when the kidneys are found, the greater the chance that education institute, national Kidney
national Kidney
for years. Until damaged and high levels of waste Foundation it can be cured. A number of new Foundation, national Kidney registry, dr.
allen nissenson, dori schatell, dr. lynda
her kidneys failed begin to accumulate in the blood. drugs are now available that show szczech, uKidney, dr. Jordan Weinstein
and she began Today, 26 million Americans have promise in managing advanced Distributed within:
dialysis, she never chronic kidney disease, yet with kidney cancer. usa today, april 2011

“the medical
realized there was a connection— early detection and control of The medical community is this section was created by mediaplanet
and did not involve usa today or its
that the high blood pressure was risk factors such as high blood turning kidney disease and kidney editorial departments.
damaging her kidneys. She didn’t
consider checking her kidney
pressure and diabetes, more than
two-thirds of new cases of kidney
community cancer into treatable and in some
cases, preventable conditions.
Special thanks:

function and her doctor never failure are preventable. Screen- is turning The National Kidney Foundation
suggested it.
Dolores isn’t alone in ignor-
ing for those at risk is essential to
finding, managing and treating kidney disease offers free screenings to those at
risk through its Kidney Early Eval-
ing her kidneys. Unless they’re
not working, most people don’t
the disease.
Kidney cancer is a related condi-
and kidney uation Program (KEEP). For those
with symptoms of kidney cancer,
focus on how integral the kid- tion that is also often found in the cancer into doctors can detect it through tests
neys are to the functioning of the
rest of the body and what to do
later stages. Symptoms include
blood in the urine or a lump in
treatable and performed in their office. The call
to action is clear. Understanding
in some cases,
folloW us on faceBook & tWitter!
to protect them. Although they the back. Smoking, obesity, kidney the kidneys’ major role in overall facebook.com/mediaplanetUSa
are fist-sized, the kidneys multi-
task 24/7 as they filter toxins from
failure and contact with harmful
chemicals are all risk factors that preventable health, knowing risk factors for
these conditions and taking the mediaplanet’s business is to create new
the blood, activate Vitamin D
to maintain healthy bones and
can be avoided or controlled. Kid-
ney cancer is treated by surgically
conditions.” time to get screened can make a
difference in the lives and health
customers for our advertisers by providing
readers with high-quality editorial
content that motivates them to act.
release the hormone that regu- removing all or part of the kidney, of thousands.

Information for people

with kidney disease
www.KidneySchool.org Kidney School is supported by an exclusive, unrestricted
educational grant from Fresenius Medical Care North America
4 · april 2011 an independent supplement by mediaplanet to usa today


a Day iN tHe PaRK

Denise Richards spends
time with her daughters
Sam and lola.
Photo: startraksPhoto.com

Question: What is the biggest lesson actress Denise
Richards took from her mother’s struggle with kidney cancer?
answer: Be your own advocate.

putting the spotlight

on kidney cancer
leader to leader
how little was known about the disease “It’s hard to raise awareness of this journey.”
and its potential treatments. At the disease because it is so rare,” she says. The biggest lesson Richards took
Kidney cancer (or renal cell time her mother, Joni, was diagnosed, “When you’re in the public eye,the big- from her mother’s struggle? Be your
carcinoma) is rare but will still there was no treatment available. By gest gift is to be a voice to raise aware- own advocate.
affect more than 50,000 people the time the disease came out of remis- ness.” She wants to help raise enough “Know your own body. When some-
this year alone. sion 18 months later, “She was able to funds to help find ways to eliminate thing’s not right, don’t take ‘no’ for an
try a couple of drugs that had just been “if you’re the cancer altogether. answer,” she says. “If you’re diagnosed
“Of everyone who has cancer, only approved, and we were waiting for diagnosed Richards says while her mother was with kidney cancer,fight.Don’t give up,
three percent of those cases are kidney another one to gain approval when she with kidney sick, she never once complained or don’t lose hope.”
cancer,” says Denise Richards, whose passed away in 2007 at age 54.” asked, ‘why me?’
mother succumbed to the disease. “Of In addition to filming public service
cancer, “She really showed me that life is a
those, 90 percent are men. So when my awareness ads, Richards is actively fight. don’t gift. Her will to live was her grandkids.
mom told me that was her diagnosis, I involved in fundraising for the Kidney give up, I never had to say, ‘C’mon mom.’ She
was shocked.” Cancer Association. She encourages don’t lose really inspired us. Anyone that’s gone michelle dalton
Even more shocking, she says, was everyone to become more involved. hope.” through cancer personally, it’s such a editorial@mediaplanet.com
An independent supplement by Mediaplanet to USA Today april 2011 · 5


family time
Denise spends quality
time with her father Irv
and her daughters.
Photo: startraksphoto.com
6 · april 2011 An independent supplement by Mediaplanet to USA Today


Surviving kidney cancer

tips for paired
Who are the best
candidates for paired
exchange? Last year, more than 1.3 mil- used to treat kidney cancer, and inside, fearing for you and them- to delay the cancer’s return, or to
■■Patients with incompatible lion new cancers were diag- will have a very positive impact selves.When cancer strikes,it hits treat metastatic disease.
or poorly compatible donors. nosed in the United States. for many patients. Continued the whole family.Your friends and The choice of treatment, where
research efforts will improve our family are rooting for you. treatment is administered, the
What donor characteris- According to the American Cancer understanding of the disease even Sometimes kidney cancer is frequency of check-ups,and many
tics matter the most? Society, more than 50,000 of these more and increase the options called by its medical name, renal other aspects of the management
■■Age of donor (under 50 pref- individuals were diagnosed with available to fight kidney cancer. cell carcinoma. Kidney cancer of your disease are determined
erable) kidney cancer. But there is hope: includes various forms, including with input from you. The more
■■Donor blood type. “O” donors More than 200,000 kidney cancer Time to start healing clear cell, papillary, sarcomatoid, you know, the better your deci-
are 10 times more powerful survivors are living in the United Each person diagnosed with kid- transitional cell, and others. sions, and the more you can feel in
than other types. States right now.Recent advances in ney cancer goes through the shock Some patients are diagnosed control of your illness. Knowledge
diagnosis, surgical procedures, and of being told they have the disease. before the cancer has metasta- about your disease will help you
Choice of transplant center treatment options will allow even It is a difficult experience. Feelings sized (spread) to other parts of better communicate with your
Many transplant centers pro- more patients to live with the dis- of shock, loneliness, alienation, the body, while others have meta- doctor and nurse, and increase
vide paired exchange services ease, continuing to maintain their fear,frustration,anger,and hurt are static disease when their cancer is your confidence in the treatment
but the differences in perfor- normal schedules and lifestyles. natural parts of any life-threaten- initially diagnosed. Surgery may that you receive. Getting smarter
mance and outcomes vary. A This marks the beginning of ing illness. It is okay to have these be the first course of treatment, about kidney cancer is an impor-
good transplant center is deter- an important new era for kidney feelings,to cry,and to be upset. or systemic treatment—that is, a tant step in effectively fighting
mined by: cancer patients, with the recent After the shock of diagnosis, treatment that is injected into the your disease.
■■How many active incompat- approval by the Food and Drug it’s time to start healing. Don’t let bloodstream or swallowed—may contributed by
ible pairs are in their pool Administration (FDA) of new drugs your emotions and your cancer be recommended prior to surgery kidney cancer association
■■How many exchange trans- to treat their advanced disease. destroy your home life or relations (though this tends to be rare). If For more information, visit
plants the center completed in These drugs target cancer cells in with the important people in your surgery is done first, additional www.kidneycancer.org
the last 12 months different ways than current drugs life. They may also be hurting treatment may be recommended editorial@mediaplanet.com
■■What percentage of the cen-

Kidney transplants: The gift of life

ter’s incompatible pool have
been transplanted since the
program started.

As a point of reference: There are almost 53,000 Dr. Titte Srinivas. Blood type com- “Living donors are heroes in
■■NKR’s average transplant people waiting for a “Living donors patibility,previous pregnancies or transplantation,” he says. Paired
kidney transplant, but
wait time is between three and
10 months. The national aver- only 16,500 are performed are heroes in blood transfusions all affect wait
list times. Socioeconomic factors
donation matches one incompat-
ible living donor/recipient pair to
age wait time is approximately
five years.
each year, according to the
United Network for Organ
transplantation.” also play a role—older, poorer
minorities and those without
another pair in the same situation.
Other advances include noc-
Sharing. Once donated, healthcare wait the longest. tural dialysis at sleep clinics,home
For further information kidneys can function for “More than half the people dialysis, and expanded criteria for
! and a free booklet on about 16 years. over age 60 will not live to see a kidney donation acceptance.
“Finding a Kidney” go to: transplant,” Dr. Srinivas says. He
www.kidneyregistry.org Wait times could improve more, advises getting on a wait list as michelle dalton
according to the Cleveland Clinic’s soon as you’re diagnosed. editorial@mediaplanet.com

Average Wait Time In Paired Exchange

National Kidney Registry 11 months

Industry Average over 4 years www.kidneyregistry.org

0 10 20 30 40 50 60
* Average wait time = pool size / transplant run rate x 12 (months). Pool size is the current active unmatched recipients in the system. Transplant run rate is the number of transplants facilitated over the past 3 months X 4 (annualized)
Aveo-KidneyHealthReport-Ad-v4.indd 1 4/18/11 2:52 PM
8 · april 2011 An independent supplement by Mediaplanet to USA Today


Don’t “a-salt” the kidneys

When it comes to dietary ■■Fresh fruits and vegetables are without any added salt.
sodium, less is certainly low in sodium. Canned and frozen ■■Try to spread your sodium
best, yet Americans today fruits and veggies are typically intake out throughout the day;
consume 50 percent more low-salt as well. But watch out it’s easier on your kidneys than
than the recommended for frozen vegetables that contain eating lots of salt all at once.
daily quantities of sodium. added seasoning or sauces, which ■■You can learn to adjust to eat-
may contain lots of extra salt. ing less salt. It typically takes
According to the National Kidney ■■Make reading food labels a about six to eight weeks on a
Foundation, diets high in sodium habit. Sodium content is always low-sodium diet to get used to it.
increase blood pressure levels. listed on food labels. After that, you’ll actually find it
High blood pressure damages the ■■Sodium content can vary from harder to eat very salty foods, like
kidneys over time,and is a leading brand to brand, so compare and potato chips.
cause of kidney failure. choose the lowest sodium product.
“As high blood pressure rates ■■Avoid spices and seasonings
have increased, kidney disease that contain added sodium, for For more information:
has spiraled to the point where it example garlic salt. Pick garlic ! The National Kidney Foun-
now affects 26 million Americans. powder instead. dation is offering a free screen-
Reducing salt intake can lower Photo: istockphoto.com ■■Many restaurants list the ings for those at risk around the
blood pressure and that may be sodium content of their products country through its Kidney Ear-
beneficial in easing the burden National Kidney Foundation. to help reduce salt intake: on their Web sites, so do your ly Evaluation Program (KEEP). To
of chronic kidney disease in this ■■Stick to fresh meats, rather homework before dining out. find a screening near you or for
country,” says Dr. Joseph Vassa- The National Kidney Foun- than packaged products, which ■■When dining out, you can also more information on salt reduc-
lotti, Chief Medical Officer of the dation offers the best tips are high in sodium. request that your food be prepared tion,visit www.kidney.org.

a future role for nutraceuticals

in chronic kidney disease?
Nearly one in eight people available to the public without
in the United States the same oversight require-
suffer from chronic ments or FDA approval. They can
kidney disease (CKD). be made readily available upon
If untreated, CKD can development, but consumers
slowly progress and as must be cautious to be sure that
it advances, leads to the the claims made for safety and
need for dialysis or kidney Dr. Allen Nissenson efficacy can be substantiated
Emeritus Professor of Medicine, David
transplantation. Geffen School of Medicine at UCLA; with solid evidence.
Chief Medical Officer, DaVita Inc. A number of nutraceuticals
CKD patients experience have now been identified to have
increasing symptoms as the strokes, and lower limb ampu- anti-inflammatory properties
disease progresses, with fatigue, tations. Research has greatly and this has raised the excit-
weakness, inability to concen- increased the understanding of ing possibility that treatment of
trate, loss of libido prominent. the mechanisms involved in the the inflammatory component
Most patients develop CKD inflammatory process. Unfortu- of CKD may be possible. A num-
because of diabetes, hyperten- nately, therapeutic approaches ber of nutraceutical companies
sion, or a combination of these to preventing or treating the are now undertaking rigorous
factors. CKD patients represent inflammation have lagged clinical research to test the value
only one percent of all Medicare behind, although considerable of these substances scientifi-
patients but consume over 10 research effort is ongoing in cally. If this research shows that
percent of all Medicare dollars. this area. nutraceuticals can provide safe
It is now known that CKD Nutraceuticals are foods and effective anti-inflammatory
patients have an increase in or food products that provide therapy, longer lives and higher
inflammation throughout the health benefits. Unlike medica- quality of life may be possible for
body resulting in an increased tions, either over the counter or CKD where inflammation is a key
propensity to heart attacks, prescription, nutraceuticals are contributor to poor outcomes.
an independent supplement by mediaplanet to usa today april 2011 · 9

loW-sodiuM crunchy leMon herBed chicken

RENAL RECIPE ingredients:

■■6 (2-ounce) chicken tenders
3. Beat egg yolk with 1 tablespoon
Fresenius Medical Care North America, the ■■4 tablespoons unsalted butter 4. Place chicken tenders between
nation’s leading network of dialysis facilities, (half chilled) two pieces of plastic wrap and
has partnered with Aaron McCargo Jr., star of Food ■■½ cup Japanese bread crumbs pound with small groove side of
Network’s “Big Daddy’s House,” to create flavorful, (Panko) mallet until thin, but not ripped.
satisfying meals for people with kidney failure. ■■¼ cup of lemon juice, plus zest 5. Dip chicken in egg wash mix-
of one lemon ture then in herbed breadcrumb
■■1 egg yolk mixture until coated.
■■1 tablespoon fresh chopped 6. Place breaded chicken in sauté
oregano pan with melted butter only after
■■1 tablespoon fresh chopped increasing heat to medium.
basil 7. Cook chicken, approximately
■■1 tablespoon fresh chopped 2-3 minutes each side.
thyme 8. Remove chicken and place on
■■3 tablespoons water (1 table- sheet tray to rest.
spoon for the egg wash, 2 table- 9. In same pan add remaining
spoons for the finishing of the herbs, salt, and lemon juice, then
sauce) heat until simmering.
10. Turn off heat; cube remaining
Preparation: 2 tablespoons of chilled butter and
1. Pre-heat 2 tablespoons of butter add to sauce (stir vigorously).
ZeSty aND HealtHy lemON on medium low heat. 11. Slice the chicken on the bias.
HeRBeD CHiCKeN is the
perfect meal for dialysis 2. Add zest of one lemon and half 12. Placed sliced chicken on a
patients—and the entire the herbs to bread crumbs, save plate, pour the sauce over the top,
family. Photos: JUaN carLos moraLEs
the rest for lemon sauce. and add garnishes.

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Reference: 1. Ranganathan N, Ranganathan P, Friedman EA, et al. Pilot study of probiotic dietary
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Adv Ther. 2010;27(9):634–647.
Kibow is a registered trademark.
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Phone: +1-610-353-5130 • Fax: +1-610-353-5110 • www.kibow.com
10 · april 2011 an independent supplement by mediaplanet to usa today

www.HomeDialysis.org inspiration

Learn how
and why to a DialySiS PatieNt SiNCe
tHe aGe Of 10, Shad ireland

do dialysis has grabbed life by the

handlebars, refusing to allow

at home
his disease to limit his abilities.
Photo: coUrtEsY oF BEN irELaND

A program of Medical Education Institute, Inc., with support from multiple sponsors.

the obstacles
■■Question: What is shad “Inspiration comes in all dif-
by Hema Assistance Products, Inc. ireland’s recipe for success? “it’s been a ferent shapes, sizes, and forms,”
■■answer: deal, accept, live.
dream of mine he says. “One of the things I say to
patients across the country is that
change since i was a kid you have to believe in the possibil-
ity of it all.”
Deal,accept,live.Those three little to be an athlete. Ireland’s current goal is to “not
words continually provide moti-
vation for two-time kidney recipi- and now, here only inspire, but to provide the
tools and resources to give other
ent and Ironman competitor Shad
i am, living that patients a format to follow.” His
belief that kidney disease “does
Typical descriptions of pro- dream. i’m living not limit your ability” comes
fessional athletes usually don’t
include diagnoses of childhood successfully through in each of his clinic visits.
He knows that initial diagnosis
HemaStrap®, the most effective product that enhances
comfort and safety for dialysis patients.
kidney disease or double kidney
transplants; but Shad Ireland is
with kidney may seem overwhelming,but that
it’s possible to live a normal and
Now you or your patients can wear the same strap that anything but typical. Once given disease.” even active lifestlye on dialysis.
many dialysis patients wear to enhances their safety — only six months to live and having By focusing on what patients can
The HemaStrap® by Hema Assistance Products, Inc. wasted away to a mere 75 pounds, do instead of what they can’t is a
HemaStrap®, to enhance your safety while on hemo dialysis. Ireland found inspiration when 2004, he became the first dialysis message Ireland will continue to
Rest easy without the fear of catching your dialysis tubing, watching the Ironman competi- patient to finish an Ironman com- spread.
leading to infiltration or needle dislodgement. HemaStrap® for tion on TV. He saw athletes “doing petition (running,swimming,and “It’s been a dream of mine since
your comfort and safety, by Hema Assistance Products, Inc. the impossible,and I wanted what biking for a combined 140.6 miles). I was a kid to be an athlete. And
they had,” he says. Ignoring the As a national spokesperson for now, here I am, living that dream.
physicians who told him he’d Fresenius Medical Care and home I’m living successfully with kid-
never compete, within 24 months dialysis, Ireland spent 2009 biking ney disease,” he says.
Ireland had bounced back and was 4,639 miles across the country to
www.hemausa.com living healthily on dialysis. raise awareness about kidney dis- michelle dalton
But that was not enough: In ease and its lack of limitations. editorial@mediaplanet.com
an independent supplement by mediaplanet to usa today april 2011 · 11



end-stage renal failure Peritoneal dialysis (PD) is
tHat fitS yOUR

(eSRD) is a devastating home-based therapy that offers associated with even better
health condition affecting clinical outcomes similar to con- outcomes. Over the last decade,
500,000 americans. ventional hemodialysis but with new strategies have emerged
some definite lifestyle advan- to expand the supply, including
Because the kidneys perform tages. In PD, the abdomen is filled paired exchange, which allows
many life-sustaining functions, with dialysate, which draws extra donor pairs who are not compat-
patients reaching this threshold of fluid and waste products out of the ible with one another to essen-
chronic kidney disease must even- blood.The vast majority of care for tially ‘swap’ kidneys with other
tually choose from a growing array PD patients takes place outside pairs whom they have never met.
options for kidney replacement. the clinical setting and allows for Paired exchange has evolved to
Hemodialysis (HD) is the most Photo: NatioNaL kiDNEY FoUNDatioN considerable portability. allow long donor-recipient chains
common form of renal replace- The ideal option is renal trans- throughout the country.
ment, which relies on a highly has allowed patients with ESRD (namely, venal needle dislodge- plantation, which is associated
sophisticated machine to filter to enhance their treatment effec- ment, which has been recognized with better life expectancy and dr. Jordan Weinstein, md
the blood.This form of dialysis has tiveness and has restored many by the Renal Physicians Associa- quality of life. As a result, demand division of nephrology, st. michael’s
seen a fairly recent proliferation patients’ quality of life.While con- tion as one of the top areas need- for this procedure has led to a Hospital; assistant professor of medicine,
in options, both in terms of inten- siderable obstacles remain in this ing safety improvement), there is deficit of organs available from university of toronto; Founder and
sity and in venue (at home vs. in treatment area,including funding tremendous optimism regarding deceased donors. Live donation director, uKidney.com
hospital). Home hemodialysis issues and various safety concerns this burgeoning therapy. is a superior alternative that is editorial@mediaplanet.com

Finding freedom with at-home dialysis

it is possible to have a work-friendly, and with treat- ■■You can do home hemodi- you live the life you want to have.
fulfilling life if you require ment each day—or at night while alysis on your own schedule, and To learn more about home dialysis
dialysis. you sleep—you will feel the posi- you don’t have to purchase the options, visit Home Dialysis Cen-
tive effects. machine. The dialysis clinic will tral at www.homedialysis.org.
How? Learn all you can, stay posi- ■■Hemodialysis is most often provide it and train you on proper *Medicare routinely pays for three
tive, take an active role in your done in a clinic. But did you know usage. Some people do short daily treatments/week.
care, and choose a dialysis treat- that some clinics offer nocturnal hemodialysis five to six days a
ment that fits your preferred life- hemodialysis three times a week week*, others opt for nocturnal
style.You have options! ReClaim yOUR life (for eight hours) while you sleep? treatments. Survival with these dori schatell
■■Peritoneal dialysis (PD) is a With new portable dialysis equipment, The long treatments are easy on options is about the same as executive director,
you can receive treatment in the
needle-free, easy to learn, portable comfort of your own home. your heart.And, they don’t disrupt deceased donor transplant. medical education institute, inc.

home treatment. PD is gentle, Photo: NXstaGE mEDicaL, iNc. your day! Your choice of dialysis can help editorial@mediaplanet.com

The quote is ‘there is no place like home’ Discover the Life-Changing Benefits of Daily

and you can’t sum it up any better than that. Home Hemodialysis with NxStage ®

This is my life, this is how I’m going to Go to www.nxstage.com/beingmeagain to request your free information kit
with the “Being Me Again” video featuring Duane and four other patient stories.
keep living my life, and this is how
I’ll see my kids grow. The NxStage System One™ is a prescription device. Daily home hemodialysis with the
- Duane, 2 year NxStage Patient System One involves risks and responsibilities which are detailed in the free information kit.
©2011 NxStage Medical, Inc. NxStage is a registered trademark of NxStage Medical, Inc. System One is a trademark of Talk to your doctor to see if daily home hemodialysis with NxStage is right for you.
NxStage Medical, Inc. CAUTION: Federal law restricts this device to sale by or on the order of a physician. APM523 Rev. A
Dialysis patients
need to make lots of

Fortunately, choosing Fresenius

is an easy one.
Making the right choices is important — about your diet and lifestyle — and especially about your dialysis care.
That’s why so many patients choose Fresenius Medical Care. Our leadership, expertise and convenient locations
make that choice an easy and confident one.
We are the leading dialysis network in the nation, with the convenience of more than 1,800 locations. We offer a
choice of treatment options including, in–center hemodialysis — with a nighttime option — and both hemodialysis
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Call our toll-free number below or find our closest location on the web.

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