We provide quality, personalized care.
Colorado Kidney Care is dedicated to advancing the science of kidney care and enhancing the quality of life for kidney disease patients throughout the region.
CKC has now expanded to 32 physicians, 9 advanced practitioners, and 11 outpatient centers. We also round at 20 hospitals and provide medical director services to 31 dialysis centers. In addition, CKC has a world class research division, provides medical director services for transplants, provides a vascular access center.
Our goal is to ensure every patient gets the best clinical outcomes, while feeling comfortable, supported and truly cared for during every step.
Colorado Kidney Care physicians are Certified by the American Board of Internal Medicine—Subspecialty of Nephrology. We provide consultative and ongoing care for patients with a myriad of kidney-related conditions such as systemic lupus erythematosis, diabetes mellitus, hypertension, kidney stones, inherited kidney disorders such as polycystic kidney disease, nephrotic syndrome, glomerulonephritis, and acute and chronic renal failure. In addition to our interest in hemodialysis therapy for the majority of our patients with End Stage Renal Disease (ESRD), we care for a large population of patients on home modalities of dialysis, including CAPD, CCPD and Home Hemodialysis. We are also the Medical Directors of the Kidney Transplant Program at Presbyterian-St. Lukes Medical Center in Denver.
One of the most common reasons for a patient to be referred to a nephrologist (a physician who specializes in kidneys), is because there was a change in your kidney function that was reflected in a laboratory result.
The most common values associated with declining kidney function are Creatinine, BUN (Blood Urea Nitrogen), and GFR (Glomerular Filtration Rate). When these are consistently out of range of “normal,” many physicians will seek the guidance of a nephrologist, or kidney specialist, to determine the root cause or causes and collaborate to provide the best possible plan of treatment. Certain medical conditions, such as high blood pressure (hypertension), diabetes, long-term use of anti-inflammatory drugs such as ibuprofen, and other reasons or conditions, may cause your physician to investigate further and subsequently refer you to Colorado Kidney Care.
Believe it or not, the kidneys are collectively the “other brain” of your body. They are responsible for important life-sustaining functions that we simply cannot survive without. In addition to the waste removal we are all familiar with (urine production), our two kidneys are literally the “generator and regulator” for a number of processes that are required for the body to function. When a patient’s kidney function declines to a point where these life-sustaining functions are no longer effective, they will need to undergo Renal Replacement Therapy (RRT). “Renal” means “having to do with the kidneys” and “Replacement Therapy” simply means something to replace the job of the non-functioning organ. RRT for a kidney care patient is either dialysis or by kidney transplant. For a great illustration of exactly what the kidneys are responsible for, please click the image below to jump to a short video.
The video is complements of The National Kidney Foundation—an organization near and dear to our hearts (and our kidneys)—is dedicated to the awareness, treatment, and prevention of kidney disease.
In the case of Chronic Kidney Disease (CKD), 1 in 3 people are at risk for developing it and, over 26 million Americans already have it—but most don’t know until it has progressed significantly. Why? Because high blood pressure, diabetes, and other stressors can lead to kidney disease and sometimes those conditions are treated without considering the kidneys. Other times, the kidneys are the culprits and their weakness or inefficiency, which can then lead to those varied conditions. It is difficult to tell which came first in some patient cases. Regardless, the kidneys are generally very “hearty” organs. However, once kidney function declines to the point of needing significant intervention, patients won’t “feel fine” anymore, inevitably experiencing symptoms and needing further intervention or treatment. Our goal at Colorado Kidney Care is to keep you “feeling fine” and keep those kidneys functioning as well as possible, for as long as possible.
Creatinine is a byproduct of normal muscle metabolism. Believe it or not, you are working muscles just by breathing. The movement of your diaphragm, which is a muscle, contributes to this metabolism; so does talking, maintaining posture, blinking, eating and, of course, exercising. Anything that uses muscles contributes to muscle metabolism and build-up of creatinine. This is normally removed by the body as waste, leaving only a small amount circulating in the bloodstream, which is why there is a normal range and not simply “zero” as the norm. With respect to kidney issues, an elevated level of creatinine in the blood is more of a “check-engine” light. Meaning there is nothing we do to try and adjust the creatinine itself because it is the result of kidney function not being up to par. To illustrate this example, think of the non-functioning kidneys as a sieve with a hole in it. That hole allows some molecules, like creatinine, to slip through to the bloodstream when they normally shouldn’t. Overtime the creatinine will build up and be reflected in lab results, signaling a potential problem with overall kidney function.
The GFR (sometimes written as eGFR) Glomerular Filtration Rate is simply a way of saying “estimated kidney function.” The functional unit of the kidney is called a “nephron”. You are born with approximately 1 million nephrons in each kidney. That number never increases and nephrons do not regenerate when permanently damaged. Within each nephron is the glomerulus, which is responsible for the first stage of the filtering process of the blood. The function of the glomerulus represents the overall function of the kidneys, expressed as a percentage. So, if your GFR is 55, then your estimated overall kidney function is currently 55%. The GFR, along with the creatinine value, is generally the starting point for evaluating the health and functionality of the kidneys.
Chronic kidney disease, or CKD, means that you have damage to your kidneys. This means that your kidneys cannot filter blood as well as they once did. CKD is generally a progressive disease and happens slowly over time. There are 5 stages of kidney disease which are based on your level of kidney function. Stages 1, 2, and often 3, can easily go unnoticed, as the symptoms are often vague or related to other conditions such as high blood pressure, fluid and electrolyte imbalance, and diabetes. Once an official diagnosis of “Kidney Disease” has been made, your primary care physician should refer you to a nephrologist or kidney care provider like Colorado Kidney Care for a consultation and maintenance of your condition.
You should not need dialysis until your kidney function is less than 20%. At that point you will begin to feel unwell and treatments/interventions are no longer effective in managing symptoms and supplementing the functions of your kidneys. This can be a very slow transition for some patients. In general, many patients do not have any obvious symptoms of kidney disease until the kidneys actually begin failing. We will work closely with you regarding options and providing information so you can make an informed decision on which type of dialysis might be right for you—long before you need it.
In general you should drink a minimum of 2-3L of non-caffeinated fluids on a daily basis. Water is the fluid of choice for patients with kidney disease, however some non-caffeinated fluids are okay as well. Electrolyte-replacement drinks are not recommended for the typical person. Please ask your physician about beverages that are best for you and what to avoid, especially alcoholic beverages.
There are several things you can do to take control of your health and help preserve your kidney function:
As your kidney function declines, your medication doses may need to be adjusted accordingly, or stopped completely. Please inform all of your physicians that you have kidney disease and what level of function you have (provide your eGFR if you are aware of that number). You should also contact your nephrologist to check with them on new medications and dosing. Everyone, regardless of kidney function, should stay away from high doses of NSAIDS (non-steroidal anti-inflammatory medications) like ibuprofen and naproxen sodium.