Services

Overview

If you or a loved one require professional kidney care, you may encounter a great number of terms or phrases that seem unfamiliar or confusing. Colorado Kidney Care encourages you to learn as much as you can about the various aspects of nephrology (the practice of caring for the kidneys) so you can be your own powerful healthcare advocate.

Nephrology

Nephrology is the medical specialty that deals with kidney disease. A Nephrologist is a doctor who cares for patients with kidney disease. You have two kidneys that are designed to perform complex jobs within your body, like removing toxins from your body as well as control the body’s balance of fluids, electrolytes, and blood pressure. Kidneys are also integral to maintaining bone health because they control vitamin D metabolism and calcium balance. Additionally, they are essential to the production of red blood cells by the bone marrow through the production of the hormone erythropoietin. Unfortunately, many diseases can affect the kidneys and cause problems for the rest of the body. Diseases that harm the kidneys include diabetes, lupus, and cardiovascular disease. As Nephrologists, we care for patients with all types of kidney disease. We also specialize in correction of electrolyte abnormalities, difficult-to-control hypertension, kidney stone prevention, and more.

Nutrition

Colorado Kidney Care provides has Registered Dietitians that provide medical nutrition therapy (MNT) appointments, which are usually about an hour long. Most insurance plans will cover MNT appointments. Topics include:

  • Chronic kidney disease
  • Diabetes (including pre-diabetes)
  •  Kidney stone prevention
  • Gout prevention
  • Weight loss diet – This is not a program, but an appointment to get started and make sure weight loss plan is safe for the kidneys.
  • High potassium or phosphorus levels

Access

Early detection and timely resolution of access dysfunction are critical to access preservation. Timely resolution leads to fewer missed dialysis treatments and a lower frequency of hospitalization.

The most common dialysis access problem is the narrowing of the access or the blood vessel attached to it. This narrowing, called “stenosis,” can lead to clotting of the access. If this happens, dialysis treatments will not be effective and the access may eventually stop flowing.

The following procedures are performed in our centers in support of optimum dialysis access health:

  • Vessel mapping
  • Angiogram
  • Angioplasty
  • Thrombectomy (declot)
  • Endovascular stent placement
  • Aneurysm and pseudoaneurysm repair
  • Accessory vein embolization/ligation
  • Hemodialysis catheter insertion, exchange, removal and repair

Transplant

Kidney transplantation is recommended for most people with end-stage renal (kidney) disease (ESRD). This is a surgical procedure in which a person with failing kidneys can receive a healthy kidney from another person. Receiving a healthy kidney via transplant allows for freedom from dialysis because the new kidney takes over the function of filtering your blood.

Undergoing a kidney transplant may prolong survival, compared to staying on dialysis. Transplantation also reduces the risk of heart disease, improves quality of life, provides freedom from dialysis, and improves energy levels.

Different types of kidney transplantation

You can receive a kidney from either a living donor (friend or family) or a deceased donor. Living donor kidneys generally tend to last longer than deceased donor kidneys.

Taking medications after a kidney transplantation

Our immune system is trained to destroy or “reject” anything it recognizes as “foreign”—which may include a newly transplanted kidney. In order to prevent your immune system from “rejecting” the new kidney, you will be placed on lifelong anti-rejection medications. Some medications have side effects that your nephrologist will discuss with you at the time of your evaluation.  

Getting referred to the transplant center

Almost all patients with kidney conditions leading to Stage 4 or 5 (GFR<30 ml/min) chronic renal failure are good candidates for transplant education and evaluation. In fact, patients that receive a kidney transplant prior to receiving dialysis have fewer complications. Your nephrologist should refer you to a transplant center as early as possible.

Dialysis

Dialysis is an artificial process of cleaning the toxins and excess water from the body when the kidneys no longer function adequately. There are different types or “modalities” of dialysis, the most common is In-Center Hemodialysis, where patients generally go three times per week. Other options include peritoneal dialysis, home-hemodialysis, and nocturnal in-center hemodialysis.  

All dialysis patients will need a dialysis access—a specialized location on your body for fluid (blood or peritoneal fluid) to travel in and out. The various types of access are:  arteriovenous fistulas (AVF), arteriovenous graft (AVG), Peritoneal (PD) catheter or a Central Venous Catheter (CVC).

As our patients prepare for the transition from Advanced Chronic Kidney Disease to End Stage Renal Disease, the CKC team members—consisting of Physicians, Advanced Practitioners, RNs, MAs and front office staff—work closely in order to make this transition a success. We educate patients on what dialysis is and how it works; various dialysis modalities; and different types of access. We work one on one with each patient to find the best treatment fit.  

The type of dialysis a patient receives will help determine where they need to go for regular dialysis treatments and how often. Dialysis treatments are typically done at a specialized hemodialysis center or at home. Our physicians and advanced practitioners continue to see our dialysis patients frequently at the dialysis units in order to review laboratories, blood pressures, and dialysis treatments. We see patients in more than  40 dialysis units, from Castle Rock and Loveland to West Lakewood and Goodland, Kansas.

Lupus Nephritis

Systemic lupus erythematosus, also known as lupus, is an autoimmune condition that causes your immune system to attack your own healthy cells. Lupus can attack any organ, and often involves the kidney. Lupus is a complex disease that has episodes of inactivity followed by flares. Most patients with lupus have both a rheumatologist (who specializes in autoimmune disease) and a nephrologist (a kidney care specialist). At the Colorado Kidney Care Lupus Nephritis Clinic,  our patients are seen by both rheumatologist Dr. JoAnn Zell and nephrologist Dr. Sarah Young.

Drs. Zell and Young collaborate to develop and put in place a comprehensive treatment plan to address patient’s kidney disease as well as other symptoms of lupus such as fatigue, rash, and arthritis. Our goal is to deliver timely and thorough treatment of lupus and any related kidney complications so patients can return to work and their families. While lupus is a chronic disease, treatment options have greatly improved and our team at Colorado Kidney Care is committed to providing the best treatment options for our patients.

Kidney SmartSM

KidneySmart is the CKD Education Program developed, written, edited and produced by a multi-disciplinary team including DaVita Medical Directors, Registered Nurses, Registered Dietitians, Licensed Social Workers, and many others who are passionate about CKD Education.In many cases, the content development teams’ were personally touched by Chronic Kidney Disease (CKD), End Stage Renal Disease (ESRD), and in one case, by kidney donation and transplant.

In an effort to provide hope and information, this comprehensive education program offers in-person classes and online resources for patients in all stages of CKD and their caregivers. The goal of Kidney Smart education is to keep patients feeling vital and on a course of well being. Find a class near your or start learning online at KidneySmart.org.

Research

Colorado Kidney Care is proud to support two clinical research divisions focused on improving the care of patients with chronic kidney disease.  Theses divisions are identified as Denver Nephrology Research Division and CKC Research Division.

Denver Nephrology Research Division.  Dr Geoffrey A Block created the Denver Nephrology Research Division (DNRD) in 1998 and serves as the Director of Clinical Research working closely with Dr. Laura Kooienga.  Dr. Block and Dr. Kooienga share research interests that include bone health, mineral disorders related to calcium and phosphorous, anemia, diabetic kidney disease, genetic disorders including Alports and Fabry’s disease and cardiovascular disease with an emphasis on cardiovascular calcification.  DNRD collaborates closely with investigators from many academic institutions including Harvard, Stanford, and Duke and with international colleagues from the United Kingdom, Netherlands, Germany, Italy, Spain, France and Australia.  The research conducted at DNRD has been influential in changing the global care of patients with kidney disease and has been cited consistently by US and International Guideline Committees.

Dr. Block has served as the Principal Investigator on more than 90 clinical trials, serves on the Steering Committee for numerous national and international trials and has authored more than 85 peer-reviewed manuscripts.  Dr. Block has served on several Technical Expert Panels for the Center for Medicare Services (CMS) and has been one of a select group of investigators from the United States to be invited to help develop international guidelines for the care of patients with chronic kidney disease.  

Colorado Kidney Care (CKC) Research Division:  The CKC Research Division is headed by Dr. Amber Podoll and includes Dr. Brad Marder and Dr. Alan Cooper.  The Division’s focus is on immunologically mediated kidney diseases including system lupus glomerulonephritis, ANCA vasculitis, IgA nephropathy, and focal segmental glomerulosclerosis (FSGS).  Patients with lupus related kidney disease are recruited for clinical trials from a multidisciplinary lupus nephritis clinic in collaboration with Dr. Sarah Young, Dr. Clancy Howard, and Rheumatologist, Dr. Joann Zell.  Dr. Podoll’s other research interests include diabetic kidney disease and acute kidney injury in patients in the intensive care unit.  Dr. Marder also studies the use of new immunomodulatory drugs in kidney transplant patients.  The CKC Research Division’s goal is to change the course of kidney injury and improve patients’ quality of life.

Options Education

Renal Replacement Therapy (RRT)

As kidney function declines and the disease progresses, a patient will need to be aware of all of their treatment options. There are a few choices of RRT that patients can consider. In order to help you make the best possible decision, our Advanced Practitioners play a large role in providing you with all of the necessary information. When patients reach the point of needing RRT, they are scheduled for an Options Education appointment at the office with the Advanced Practitioner. Patients are encouraged to bring family members, close friends, or anyone who may be of support. They are also encouraged to come to the appointment with questions for the Advanced Practitioner in order to make the best decision for their lifestyle and clinical status. The Options Education appointment will include an overview of all kidney-related RRT options,such as Peritoneal Dialysis, Hemodialysis, and Kidney Transplant. However not all options are viable for each patient. The Advanced Practitioners are well-versed in each patient’s conditions and will discuss the options that are appropriate for that individual. Learn about various Renal Replacement Therapies:

https://www.kidney.org/atoz/atozTopic_Dialysis

https://www.kidney.org/transplantation

Care Coordination

Nurse Care Coordinators

The Colorado Kidney Care team of Registered Nurses works closely with our patients to ensure we provide the best possible care across our practice. We work as a unified team to make keep patients well informed of their clinical status, and to provide them with the information they need to actively participate in their own care. One of the most important functions of our nursing team is the Care Coordination of our Chronic Kidney Disease patient population. As patients experience declining kidney function, our nurses carefully guide them through various milestones of care. The goal of this Care Coordination is to provide the best possible medical care for CKD patients, and to help them prolong kidney failure or RRT as long as possible. In the event RRT is needed, we are dedicated to making the transition to dialysis or transplant as smooth as possible. We work diligently to keep patients as healthy as possible, and feeling as well as can be expected. The RNs are key in educating patients during the disease progression, monitoring lab results, and providing guidance on medications and nutrition—all the while be mindful of an eventual transition to Renal Replacement Therapy.