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Center for Renal Education

The Center for Renal Education provides education about Chronic Kidney Disease and its management and individualized plans of care that include nutritional counseling, blood pressure management, medication review and supportive services.

The MGH Center for Renal Education provides a support service for patients and their families where information concerning renal replacement options including hemodialysis, peritoneal dialysis, and transplantation is offered.

In collaboration with MGH nephrologists, experienced renal nurses, a dietician, and social worker, the Center provides education about Chronic Kidney Disease and its management with individualized plans of care that include nutritional counseling, blood pressure management, medication review, and supportive services. The team is dedicated to help patients with renal disease live a full and happy life.

The MGH Center for Renal Education has also received the 2000 Partners in Excellence Award for its leadership, innovation, quality treatment, and outstanding commitment to patient service.

What do kidneys do?

The kidneys are two of the body's most important organs. They are responsible for filtering the blood and eliminating waste products and excess water in the form of urine. Kidneys also help regulate blood pressure, make new red blood cells and maintain healthy bones. The kidneys are located below the rib cage and next to both sides of the spine (backbone). They are shaped like kidney beans. Some people are born with one kidney, which may be larger than average. The body can still function with one healthy kidney.

 

What are the reasons for kidney disease?

  • Diabetes: Kidney Disease can be a complication of diabetes. Poorly controlled blood sugar damages the blood vessels in the kidneys; diabetes is one of the leading causes of kidney disease.
  • Hypertension (High Blood Pressure): Poorly controlled hypertension can damage the small vessels within the kidneys. The kidneys then become diseased and will no longer function normally.
  • Glomerulonephritis: This causes inflammation of blood vessels in the kidneys; this process can damage healthy kidney tissue.
  • Polycystic Kidney Disease (PKD): Fluid filled sacs (i.e. cysts) are formed inside of the kidneys. Normal tissue is replaced by these cysts.
  • Medications/Toxins: Unusually heavy use of pain medication such as ibuprofen may cause kidney damage. Toxins, heavy metals, and/or X-Ray dyes may also harm the kidneys.
  • Kidney Stones: A collective mass commonly called stones can damage kidney tissue or block drainage from the kidneys creating permanent damage.
  • Lupus: A connective tissue disease that affects all organs of the body including the kidneys.

 

There are several words associated with kidney disease that are helpful to understand:

  • Renal - The Latin term for kidney is "ren." Renal disease refers to diseases related to the kidney.
  • Nephrologist - The Greek term for kidney is "nephro." A nephrologist is a physician who specializes in the medical treatment of kidney disorders.
  • Acute Renal Failure - This term refers to sudden loss of kidney function. This can be either temporary or permanent.
  • Chronic Renal Disease - Refers to long term damage of the kidney
  • Renal Insufficiency - Applied to when kidney function has decreased, but the kidneys are still partially working.
  • End Stage Renal Disease - This is the stage where the kidneys have stopped working. Dialysis or transplantation (renal replacement therapy) are needed at this stage to maintain life.

 

How do you know if you have kidney disease?

Symptoms can include:

  • Unusual fatigue, nausea, vomiting
  • Change in the appearance of urine (red, dark brown, and/or foamy)
  • Unusual change in your daily urination pattern (increased/decreased amounts, constant frequency, burning sensation, and/or the need to urinate constantly during night)
  • Swelling of ankles, hand, and/or face
  • High blood pressure
  • Unusual shortness of breath, difficulty breathing
  • Changes in taste and/or bad breath

 

What can be done?

  • See your Primary Care Physician as soon as possible
  • A nephrologist may be consulted to help in your care
  • Certain blood tests, imaging tests (X-Rays, scans, etc.), and/or a kidney biopsy may be ordered to confirm kidney disease
  • Medical care and constant follow-up is very important to successful management of the disease

 

Can kidney disease be cured?

Most types of kidney disease become progressive or worsen over time. However, it is possible to slow the progression of some types of kidney disease with good healthcare management. Close and continous follow-up with your primary care physician and nephrologist is very important.

 

How can kidney disease be controlled?

  • If you have diabetes, careful control of your blood sugar is very important. Evidence consistently shows that careful control of your blood sugar in insulin-dependent diabetes can slow the progression of kidney disease.
  • Your physician and dietician can help you control your blood sugar through diet, exercise, and medication.
  • Hypertension is often a silent disease without noticeable symptoms. Controlling high blood pressure with diet, excercise and medications can help to slow the progress of kidney disease. Careful follow-up with your healthcare team to control high blood pressure is very important. A blood pressure of 120/80 mmHg or less is best.

 

Reducing dietary protein

Low protein diets may be helpful in slowing the progression of kidney disease. Your physician and dietician can determine if you are a candidate for a low protein diet. Do not start a low protein diet without the guidance of your primary care physician and dietician.

 

Maintaining Healthy Bones

Normal kidneys maintain healthy bones by balancing calcium and phosphorus. This can still be achieved as kidneys begin to fail with medications and a low phosphorous diet. Careful and continous follow-up of blood values are necessary.

 

Correcting Anemia

Normal kidneys always make a substance called erythroprotein, which helps the body make red blood cells. When kidney function decreases, less erythroprotein is made. Thus, anemia (a deficiency of red blood cells) can develop, causing further complications. Fortunately, anemia can be corrected through medications prescribed by your doctor. For example, Epoietin Alpha is a medication that replaces erythroprotein. Careful and continous follow-up of blood values and blood pressure are necessary.

 

What if my kidney disease becomes worse?

When your kidneys fail or stop working, dialysis is needed to maintain life. Dialysis is a form of kidney replacement therapy to remove waste products from the blood and regulate fluids.There are two kinds of dialysis:

  • Hemodialysis: Involves cleaning or filtering the blood through an artifical kidney machine. This procedure is performed by nurses and technicians in a dialysis center several times a week.
  • Peritoneal Dialysis: Involves a solution flowing from a bad through a special tube into the abdominal cavity. Waste products and extra fluid from the blood are removed through this tube. The home peritoneal dialysis self-dialysis patient is trained, supported, and continously followed by peritoneal dialysis nursing staff members.

 

Am I a candidate for a kidney transplant?

Some patients may be candidates for a kidney transplant procedure. The kidney may be donated by a family member, an unrelated donor, or a cadaver donor.

 

Who can help me with my kidney disease?

You are the most important member of the healthcare team. You can help us by actively participating in your care. Other members of your healthcare team include:

  • Your primary care physician
  • Nephrologist
  • Other doctors involved in your care
  • Renal nurse, dietician, and social worker

 

Who can I talk to?

Being diagnosed with kidney disease can be stressful for you and your family. Now that you have been diagnosed with kidney disease, you may be asked to make some changes in your life. Your healthcare team understand how hard this is for you and wants you to know we are available to help you throughout the process.

You may be asked to change your eating habits and/or begin taking medications to help treat your kidney disease. Changes are often difficult to deal with when you are adjusting to a new diagnosis, going to medical appointments, and learning new ways to take care of your health.

You may feel overwhelmed and/or nervous. These feelings are perfectly normal and if you feel this way, you may find it helpful to discuss your concerns and fears. Although some people are not comfortable expressing their feelings, doing so can help to reduce anxiety.

Your family and friends can also be a source of support. The renal social worker and entire healthcare team are available to help you through this process as well.

The most important thing to remember is that you are not alone. Your healthcare team will work together with you and your family to get through this difficult time and successfully make the needed changes in your life.

Related Conditions

The links below provide more information about the conditions and diseases that might be treated within this program.

Analgesic Nephropathy

Analgesic nephropathy is a chronic kidney disease that gradually leads to end-stage renal disease and the need for permanent dialysis or a kidney transplant.

Anemias

There are many types of anemias that require clinical care by a physician or other healthcare professional. Listed in the directory below are some, for which we have provided a brief overview.

Diabetic Nephropathy (Kidney Disease)

Nephropathy is the deterioration of the kidneys. The final stage of nephropathy is called end-stage renal disease, or ESRD.

End Stage Renal Disease (ESRD)

Renal failure refers to temporary or permanent damage to the kidneys that results in loss of normal kidney function.

Glomerulonephritis

Glomerulonephritis is a type of glomerular kidney disease in which the kidneys' filters become inflamed and scarred, and slowly lose their ability to remove wastes and excess fluid from the blood to make urine.

Glomerulosclerosis

Glomerulosclerosis is the term used to describe scarring that occurs within the kidneys in the small balls of tiny blood vessels called the glomeruli.

Goodpasture Syndrome

Goodpasture syndrome is a rare, autoimmune disease that can affect the lungs and kidneys.

Hematuria (Blood in the Urine)

Hematuria is the presence of red blood cells (RBCs) in the urine.

Hemolytic Uremic Syndrome

Hemolytic uremic syndrome is a rare condition that mostly affects children under the age of 10. It is often characterized by damage to the lining of blood vessel walls, destruction of red blood cells, and kidney failure.

Immunoglobulin A (IgA) Nephropathy

IgA nephropathy is a chronic kidney disease that may progress over a period of 10 to 20 years, and can lead to end-stage renal disease.

Nephrotic Syndrome

Nephrotic syndrome is a condition often characterized by the following: very high levels of protein in the urine, low levels of protein in the blood, swelling, especially around the eyes, feet, and hands, as well as high cholesterol.

Polycystic Kidney Disease

Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts filled with fluid in the kidneys.

Renal Vascular Disease

Renal vascular disease is the name given to a variety of complications that affect the arteries and veins of the kidneys.

Promoting kidney health

LAURIE BIEL, RN, BSN, CNN, of the MGH Center for Renal Education, does not know whether the kidney or the kidney bean was named first – but she does know a great deal about kidney health.

Center for Renal Education

165 Cambridge Street
Suite 504
Boston, MA 02114

Phone: 617-720-2774
Fax: 617-720-2861