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  1. 1. An independent supplement by mediAplAnet to chicAgo tribune No.2 / August 2010 KIDNEY HEALTH 3 REDUCING RISK AND TIPS RAISING AWARENESS Alonzo Mourning overcame his battle with kidney disease, becoming a champion on and off the court strength in numbers Kidney 101 Join the fight to how well do stop polycystic you know your kidney disease kidneys?
  2. 2. 2 · August 2010 An independent supplement by mediAplAnet to chicAgo tribune CHALLENGES You are born with two kidneys. They start life behind the bladder in the unborn fetus and then “grow” up your back into their final position just below the rib cage. Understanding your kidneys We recommend Alonzo Mourning K Alonzo inspires with his battle against kidney idneys reach diagnosed by measuring a blood fully control blood pressure, espe- disease. pAge 6 maximum func- chemical (creatinine) which is then cially with the use of drugs such tion at approxi- used to estimate GFR (eGFR).A urine as ACE-inhibitors and ARB agents. Help those with kidney mately age 10 and test is done, looking for abnormal These drugs have been shown to disease by discussing healthy eating options p. 4 ultimately weigh cells or protein.The combination of slow kidney disease. Low salt and create a healthy diet for your kidneys about five ounces urine tests and eGFR divides CKD avoidance of a high protein diet are Fighting PKD each.Despite their into Stages 1 through 5. Stage 5, also important. Treatment of bone dis- through research p. 7 Join the battle against polyscystic small size,they receive about 25 per- known as “end stage kidney dis- Leslie Spry MD, FACP, FASN ease and anemia may be necessary. kidney disease cent of the heart output and cleanse ease,” is when eGFR is less than 15. spokesperson for the national Treatment of infections and block- Kidney Foundation the entire volume of blood many At that point, patients are very sick age in the bladder or kidneys will times per day. How well the kidney and may need dialysis treatment or facts preserve kidney function. Main- functions is expressed as glomeru- a kidney transplant to replace the taining ideal body weight with diet lar filtration rate (GFR.) Normal GFR job normal kidneys would do for Common causes and exercise is desirable. Choles- is 90–100 percent. them. The most common causes of terol treatment, careful manage- In addition to cleaning blood,kid- 1 kidney disease are diabetes ment of diabetes and heart disease, neys correct salt and water imbal- Screen before and high blood pressure. and avoiding smoking will keep ance.They release and regulate hor- symptoms strike kidneys functioning longer. mones important in bone health Kidney disease may be totally with- Diagnosing CKD High blood pressure, diabetes, and in the manufacture of red blood out symptoms. Because early detec- Chronic kidney disease hardening of the arteries and other cells. They regulate blood pressure tion can slow or prevent progres- 2 (CKD) is diagnosed by mea- kidney diseases may hasten the loss and important chemicals in the sion to kidney failure, the National suring a blood chemical (creati- of kidney function. Be good to your blood including sodium,potassium, Kidney Foundation recommends nine) which is then used to esti- kidneys so they will last you the rest calcium, phosphate, magnesium blood and urine testing for CKD in mate GFR (eGFR). A urine test is of your life. The National Kidney and acid. The kidneys also remove everyone at risk—those with high done, looking for abnormal cells Foundation offers free screenings toxins and drugs from the body. blood pressure, diabetes, or fam- or protein. through its Kidney Early Evaluation ily history of either. Those who are Program (KEEP). For information Diagnosing kidney disease elderly or people with heart disease Blood and urine testing on local KEEP screenings and to The most common causes of kidney and family history of kidney disease The National Kidney Foun- learn about kidney disease,visit the disease are diabetes and high blood as well as racial minorities includ- 3 dation recommends blood National Kidney Foundation web- pressure. There are also inherited ing African-Americans, Hispan- and urine testing for CKD in site at Kidney HealtH kidney diseases such as polycystic ics, Asians, American Indians and everyone at risk—those with 2nd edition, august 2010 kidney disease and Alport’s syn- Pacific Islanders, are all at high risk high blood pressure, diabetes, or Country Manager: Jason Howell drome. of CKD and should be screened. family history of either. Editorial Manager: Jackie mcdermott Chronic kidney disease (CKD) is Patients with CKD should care- responsible for this issue Publisher: matthew adams HoW i made it Business Developer: lee auerbach ■■Frank Germinaro of Kenosha,Wis- Frank ductor/musical director of the Keno- Kidney Foundation. He’s served on consin, set a record last March when Germinaro sha Pops/Concert Band, is still over- the organization’s patient family Designer: missy Kayko germinaro he celebrated an anniversary—his participated in the whelmed with gratitude.He received council and on a special workgroup 40th year with a kidney donated to 2010 national Kid- the kidney of a 13-year-old girl who that developed practice guidelines Contributors: him. To celebrate this landmark, ney foundation died of a brain tumor and thinks for kidney specialists. Germinaro dori schatell, Jill smits, national u.s. transplant Kidney foundation, Polycystic Kidney Germinaro participated in the 2010 games. about her family’s sacrifice. “She was spoke at the NKF 2010 U.S.Transplant disease foundation, tim radway National Kidney Foundation U.S. a young girl with a future ahead of her Games Donor Recognition Ceremony Distributed within: Transplant Games, which took place with kidney disease as an infant, he and I was a young guy who needed a this summer,where he tried his hand chicago tribune, august 2010 in his home state this summer. was a chronically ill child who was future and I’ve been able to have one in the event’s golf competition. this section was created by mediapla- Germinaro, who outlived the hos- hooked up to a dialysis machine. because of her,” says Germinaro. “I am honored to have been asked net and did not involve the chicago tribune or its editorial departments. pital where he was transplanted, Today, the married father of four Germinaro,who is the owner of one to speak at the ceremony,” Germinaro never dreamed he’d have to think grown children who’s enjoyed a of the longest-lasting kidneys in the says. “As for golf, I am a better cheer- Photo credits: unless about things like gray hair.Diagnosed U.S.,gives back through the National leader than participant!” otherwise noted career as a school principal and con-
  3. 3. An independent supplement by mediAplAnet to chicAgo tribune August 2010 · 3 NEWS 1 TIP Question: Is it possible to have a good life on dialysis? tiPs Answer: Yes. Learn all you can about dialysis, keep a CHooSE A Kidney stone treatment: shock wave lithotripsy positive attitude, and take an active role in your care. TREATMENT THAT FITS YoUR 1. What is shock wave lithotripsy? Shock Wave Lithotripsy (SWL) is PREFERRED LIFESTYLE the most common treatment for kidney stones in the U.S. Shock waves from outside the body are targeted at a kidney stone causing the stone to fragment. The stones are broken into tiny pieces. lt is sometimes called Living a good life on dialysis ESWL: Extracorporeal Shock Wave Lithotripsy. 2. What is ureteroscopy? It is a procedure in which a small scope (like a flexible telescope) is inserted into the bladder and longer. Most Americans with The clinic provides the machine ureter and it is used to diagnose Kidney failure is not the end ■ Ability to keep a job kidney failure go to a clinic three and trains you and a partner and treat a variety of problems of the world. It is possible to ■ Ease of travel times a week for “standard” until you’re confident. Perito- in the urinary tract. For ureteral have a good life on dialysis. three to four hour hemodialysis ■ More energy neal dialysis, which uses the ■ Better sleep stones, it allows the urologist treatments. These leave a two- inner lining of the abdomen as to actually look into the ureter, How? Learn all you can, keep a day gap—with no treatment at Your sex life and chance a filter, is easy to learn and do, of having a child may also find the stone and remove it. positive attitude, and take an all—each weekend, which is and requires no needles and improve, too. The surgeon passes a tiny wire active role in your care. And— hard on the heart. no partner. basket into the lower ureter via most important of all—choose Dialysis is best done longer Nocturnal hemodialysis can Your choice of dialysis can let be done at night while you sleep the bladder, grabs the stone and a treatment that fits your pre- or more often. For you, this you live the life you want to have. pulls the stone free. This is an can mean: in a clinic, three times a week, ferred lifestyle. outpatient procedure with or for twice as much treatment as Healthy kidneys work 24/7 to ■■ A more normal diet without a stent inserted (a tube the “standard.” Or, you may be filter wastes and excess water ■■ Fewer fluid limits or meds doRi ScHatell that is placed in the ureter to able to do home hemodialysis, executive director, medical out of your blood. When your to take hold it open). at night or as short daily treat- education institute, inc. treatment closely mimics this, ■■ Control of your schedule However, depending on the skill ments five to six days a week. you’ll feel better, and may live and experience of the surgeon,ure- teroscopy can be used for virtually any stone of a size appropriate for it. Fragmentation of stones using helium laser device ureteroscopy is more assured than with shock wave lithotripsy (SWL). 3. When is ureteroscopy used? Most often ureteroscopy is used for stones in the ureter,especially for stones closest to the bladder, in the lower half of the ureter. lt is the most common treatment of lower ureteral stones. For stones in the kidney, shock wave Kovler lithotripsy (SWL) is the most Diabetes common treatment. SWL treat- ment cannot be used in everyone. Center For patients who are pregnant, Comprehensive, morbidly obese, or have a blood There’s no place like clotting disorder, ureteroscopy customized care for is a good choice. For very large or infants, adolescents oddly shaped stones, or stones and adults with that are very hard, other treat- Your one-stop source for PD & home hemo info & support ments such as percutaneous diabetes nephrolithotomy or, rarely, open surgery may be needed. Created by the non-profit MediCal eduCation institute, inC. with support froM Multiple sponsors source: national Kidney foundation
  4. 4. 4 · August 2010 An independent supplement by mediAplAnet to chicAgo tribune 2 TIP NEWS HELP THOSE WITH KIDNEY DISEASE BY DISCUSSING HEALTHY EATING OPTIONS BE MINDFUL oF PoRTIoN SIZE According to the What is safe? ■ Be mindful of portion size American Diabetes A solid plan is limited in phospho- ■ Eat lots of fruits and Association (ADA), diabe- rus, potassium and sodium, making vegetables tes is the leading cause of it ideal for renal patients. Since the ■ Choose whole grains over kidney failure with 23 food industry adds phosphates to processed grains million children and foods that are typically considered ■ Eat fish two to three times adults having some type low-phosphorus, this makes it diffi- a week of diabetes in the United cult to know what is “safe” and what According to Paula Heaton, RN, States. should be limited. In fact, the USDA BSN, of SSHE, “Prevention is key. does not require values for phospho- Limit sodium intake, eat healthy The most common being Type 2, rus and potassium to be included in and drink plenty of water. She says accounting for nearly 95 percent food labels. if you are overweight and diagnosed of all adult cases. Companies such as Seattle Sut- CoNTRoLLED DIET. Pocket pita with aged Swiss cheese, garbanzo beans and with high blood pressure and/or Once diagnosed with kidney ton’s Healthy Eating (SSHE) have fresh garden greens all tucked in a whole wheat pita pocket with a refreshing yo- Type 2 diabetes, weight loss may gurt cucumber dressing and petite orange. Photo: seattle sutton disease, it’s important to limit been helping people at risk of devel- help you manage these conditions sodium, phosphorus and potas- oping kidney disease and those appeals to those with health issues disease,” says Seattle Sutton. “Since and help avoid chronic kidney dis- sium in your diet. Also, you need living with it for the last 25 years such as kidney disease, diabetes controlling weight is a matter of ease.” to adhere to a strict diet in order since registered nurse, Seattle Sut- and heart disease, as well as anyone calorie intake versus output,a calorie For more information about to keep laboratory values within ton, started the company. SSHE is a wanting to eat a balanced diet. controlled diet is an important factor SSHE,go to or call healthy ranges. Follow your doc- freshly prepared, calorie controlled, in maintaining healthy kidneys.” 1-800-442-DIET (3438). tor’s orders with regard to nutri- low fat, low cholesterol and sodium Preventative measures The ADA recommends the fol- tion, appointments, follow-ups restricted meal plan that includes “Obesity is a key issue with Type 2 lowing basic tips to help prevent Jill SmitS and medications. fresh fruits, vegetables and salads. It diabetes and preventable kidney diabetes: Think Smart Think Healthy Name Surname duis autem vel Our Plan Offers: 3 Freshly prepared, healthy meals Think Seattle Sutton’s Healthy Eating eum iriure dolor in hendrerit in vulpu- tate velit esse mo- 3 Nationwide availability 3 Delivery to home or office available lestie consequat, vel illum dolore eu 3 Fresh fruits, salads and vegetables Byline 3 Portion and calorie controlled Seattle Sutton’s Healthy Eating feugiat nulla . 3 Choice of portion size: 1,200 and 2,000 calorie plan per day is the answer to your healthy eating dilemma! 3 Nutritionally balanced diet (ingredient label & nutrition facts on every meal) 1/3 page Our meal plan is helpful for: 3 Low fat, low cholesterol and sodium restricted • Convenience • Blood Pressure Control 3 No hydrogenated or partially hydrogenated oils = zero trans fat • Heart Healthy Eating • Diabetes Prevention and Control 3 5-week menu rotation (105 different meals) 3 No contracts or enrollment fees • Weight Reduction and Management • Lowering Cancer Risk 10 x 3 inch • Reducing Cholesterol Levels 3 No counseling sessions or meetings to attend Look at these Fantastic Results… 3 All the shopping, preparing and cooking for you I’ve dropped over I no longer need to take Seattle Sutton’s Healthy 3 No hormones, additives or antibiotics in poultry served 80 lbs. and gone from medication for high blood Eating has helped me size 3X to a size 12. pressure and my lose 102 pounds in 3 No artificial sweeteners, food dyes, harmful additives or preservatives Mary O. cholesterol is way down. 10 months! 3 No high fructose corn syrup Bill E. Maria K. 1-800-442-DIET(3438) The above are based on an average of a 5-week menu analysis of all meals per day. *1,200-calorie plan contains less than 2000 mg of sodium/day, whereas USDA recommends a goal of less than 2,300 mg/day ©2010 Seattle Sutton’s Healthy Eating (approximately 1 teaspoon) for daily sodium intake.
  5. 5. An independent supplement by mediAplAnet to chicAgo tribune August 2010 · 5 NEWS Question: What are probiotics? don’t miss! Answer: Probiotics and kidney health probiotics are healthy bacteria that The Kidney Cancer Association enter the body through supplements or probiotic-rich foods such as yogurt, (KCA) is the world’s leading orga- nization devoted to providing kefir and sauerkraut. support for people diagnosed with kidney cancer. Resources include: ■ The most comprehensive kidney cancer website available,, featur- Probiotics: Impact on kidney health ing educational videos, updates on treatment options, patient testimonials, support hotlines, links to clinical trials and much There is a growing sity researchers released a study probiotic dietary supplement that more. Access to information in awareness of probiotics and that found people who naturally “our researchers would help maintain healthy kid- multiple languages is provided. their potential benefits, par- carried a bacterium called Oxa- have developed ney function.” The supplement ■■Major conferences, including ticularly on digestive health lobacter formigenes were less may possibly benefit patients by a yearly international sympo- issues such as Irritable likely to develop kidney stones. an inexpensive metabolizing nitrogenous waste sium that brings together the Bowel Syndrome or Crohn’s While investigators emphasized probiotic dietary products in the bowel, which in world’s leading researchers in Disease. that more research was neces- sary, the findings suggested that supplement that turn aids the excretory function of the kidneys.The hope is that it will kidney cancer. ■■Fundraising initiatives to Research using O. formigenes as a probiotic would help possibly postpone dialysis and help support research,education There is little scientific evidence to support some uses of probiot- may reduce the risk of developing kidney stones. maintain healthy potentially reduce the frequency and/or duration of dialysis once and advocacy. ■■An active support community ics, but a great deal of research is kidney function.” it becomes necessary. Three addi- that puts patients and families underway to determine whether Potential Nataranjan Ranganathan tional human trials are planned in touch with each other to share ceo, Kibow Biotech “good” bacteria may have a posi- Some have even greater hope to investigate the supplement’s resources and build hope. tive effect on a number of health for probiotics’ impact on kidney developed a probiotic supplement effects. You can help by making a dona- problems including tooth decay, health. Natarajan Ranganathan, aimed at patients with kidney tion—visit www.kidneycancer. skin infections and kidney PhD, is interim CEO at Kibow problems. He says, “Our research- Jill SmitS org or call 800-850-9132. stones. In 2008, Boston Univer- Biotech, Inc., a company that has ers have developed an inexpensive Biotherapies for LifeTM CSL Behring is committed to saving lives and improving the quality of life for people with rare and serious diseases worldwide. Through our continued focus on innovation, we are leaders in developing new and enhanced plasma-derived and recombinant biotherapies, with a 100-year heritage of quality and safety. We offer the industry’s most robust product portfolio delivering “Biotherapies for Life.”
  6. 6. 6 · August 2010 An independent supplement by mediAplAnet to chicAgo tribune INSPIRATION 3 TIP Question: How did one of the best big men on the court in NBA history overcome kidney disease and go on to inspire and educate the masses? Answer: By using his lifelong mindset of not letting anything stop him from accomplishing his goals, BE AN oRGAN he beat the illness and became a champion both in the NBA and for advocating kidney research. DoNoR Alonzo Mourning uses NBA fame to fight kidney disease In october 2000, unsure about my future…looking ing’s true passion as he encour- Mourning was diagno- for answers. It was just like going “tremendous aged everyone to “become an sed with focal segmen- tal glomerular sclerosis into a classroom for the biggest test of your life without study- strides have been organ donor... (It) is one of the most important things in the (FSGS), a kidney ing,” he says. made and the fight against kidney disease. It’s disease that causes scarring in the glomeru- A second chance best is yet an amazing gesture,” he says. li, the blood vessels and new battles to come.” Hope for the future in the kidneys that Mourning received a kidney Mourning also expressed how filter the blood to transplant in late 2003 from excited he is about his future make urine. a cousin with whom he had Alonzo Mourning work with Zo’s Fund For Life. fallen out of touch. This enabled “Tremendous strides have been Mourning was obviously unset- Mourning to play a key role in the use his celebrity to touch many created in 2001 to “be an inspira- made and the best is yet to come.” tled by this news in the midst of a Miami Heat’s 2006 NBA Champi- more lives off the court to help tion, and ensure communication Hall of Fame-caliber NBA career. onship. fight the battle against kidney and prevention of kidney dis- tim RadWay “I was devastated, scared, and Mourning knew that he could disease. “Zo’s Fund For Life” was ease.” This has become Mourn- For the past 40 years, nephrology practice in Chicago to WE GIVE YOU Associates in Nephrology establish a vascular lab,Associates Miami Transplant Institute has provided high-quality, in Nephrology has over ten years of Another chance compassionate care to experience in providing vascular patients with kidney access services in three locations. disease and hypertension In 2006, Associates in at life. throughout the entire Nephrology was the recipient Chicagoland area. of the prestigious Renal Physi- cians Association (RPA) Exem- Conveniently located outpatient plary Practice Award. This award clinics provide AIN the opportu- recognizes a nephrology practice nity to identify, educate and treat that uniquely incorporates and patients in the first stages of kidney supports the strategic efforts disease. Our physicians are recog- of the RPA to optimize the high- Miami Transplant Institute nized not only for their innovative patient service programs, but also est standards of medical care Celebrating 40 Years of Excellence for being actively engaged in initia- for patients. Beginning with the first kidney transplant in 1970, our program has For a complete list of physi- tives to improve patient outcomes grown into one of the largest and most comprehensive solid organ cians and practice locations, transplant centers for adults and children. Today we perform over through outreach efforts in the please visit our website www. 500 transplants annually, placing the University of Miami/Miller local community. School of Medicine and Jackson Memorial Hospital in the elite AIN’s thirty-two board-certified high volume transplant centers in the nation. We save lives by nephrologists provide compre- 210 South Des Plaines Street providing the most advanced patient care, research and education hensive services to approximately Chicago,Illinois 60661 in organ and cellular transplantation. 2,500 dialysis patients in over 150 (312) 654-2720 site locations, including hospi- tals, nursing homes, out-patient and dialysis facilities. As the first pAid For by AssociAtes in nephrology
  7. 7. An independent supplement by mediAplAnet to chicAgo tribune August 2010 · 7 PANEL OF EXPERTS Seattle Sutton, RN, BSN Dr. John Milner George W. Burke III, MD, FACS founder & President Kidney transplant surgeon, chief, division of Kidney and Pancreas seattle sutton’s, Healthy eating director, loyola’s living donor Program transplantation; director, lillian Jean Kaplan renal transplantation center Question: What are the main components in plan- Question: What has been one of your professional Question: What are the advantages to receiving a ning and preparing a healthy meal for a kidney patient? highlights? kidney transplant that would influence my decision to Answer: Kidney patients need to limit sodium, phos- Answer: I have helped pioneer Loyola’s innovative Pay- choose it over remaining on dialysis? phorus and potassium. They also need to limit pro- it-Forward Kidney Transplant Program, which begins Answer: Most kidney transplant recipients appreciate cessed foods and frozen meals, since they often have when an altruistic donor donates a kidney to a stranger, a benefit from the perspective of lifestyle (more free time, unhealthy levels of sodium and phosphate additives beginning a chain. The donor’s kidney then goes to a able to travel/vacation without planning for dialysis, in them. Dining out can also be challenging, because compatible transplant candidate who has an incompat- etc.), although clearly there is a risk/benefit ratio inher- there’s no ingredient list. It’s essentially a mystery ible donor who agrees to give a kidney to a third person ent in the decision, and following kidney transplanta- meal. Food in the simplest form is typically the with an incompatible donor, and so on.A chain could go tion, recipients need to continue lifelong immunosup- healthiest and best in a portion-controlled diet. on forever. pressive medications. Furthermore, there are data over the past decade that support increased survival of those patients who receive a kidney transplant vs. those who remain on dialysis. Question: What are some misconceptions about Question: What’s special about the approach you’ve Question: What is the most significant factor that a healthy diet? taken? impacts long-term kidney transplant graft survival? Answer: Eating healthy doesn’t taste good. That is Answer: My colleagues and I have created a radical Answer: Historically rejection was the most impor- not true. As you consume healthy, freshly prepared shift in how kidney transplants are performed. What tant contributor to loss of kidney transplant function. meals you will develop new tastes. traditionally happens is hospitals will keep an altruistic More recently,the rate of acute rejection is less than 10 Some diabetics think they can’t have sugar.That is not donation within its walls and get only one transplant percent in most centers.The greatest impact currently true—none of us including diabetics need concen- done. We, however, view these donors as national trea- to long-term graft survival generally involves other trated sweets.Also, portions matter. sures and not institutional commodities. Our primary medical issues, for example, hypertension, diabetes, “Natural” and “light” are better. Both are misleading, goal at Loyola is to get more patients transplanted with cholesterol (dyslipidemia), obesity and underlying because there is no definition to label food as such. the best matched kidney,no matter where they live in the heart and vascular disease.As these come under better United States. medical control, we expect to see an improvement in long-term kidney transplant survival. Fighting PKD through research Polycystic kidney not skip a generation. Fortunately, there is hope. The disease or PKD is one of The devastating disease comes PKD Foundation is the only orga- the world’s most common, in two hereditary forms: nization in the world dedicated to life-threatening genetic ■■Autosomal Dominant Poly- fighting PKD through research, diseases, often causing cystic Kidney Disease (ADPKD): education, advocacy and aware- kidney failure and death. ADPKD affects one in 500 world- ness. Since 1982, the PKD Foun- PKD causes cysts to grow wide. Parents with the dominant dation has funded millions in on the kidneys, eventually form of PKD have a 50 percent critical research. Thanks to this leading to kidney failure. chance of passing the disease on critical support, the development to each of their children. of new drug therapies offer help Parents with the disease have a 50 ■■Autosomal Recessive Poly- and hope to the 12.5 million peo- percent chance of passing it on to WALK FoR PKD. The Walk for PKD is the national fundraising and awareness event cystic Kidney Disease (ARPKD): ple worldwide suffering from the for the PKD Foundation. Chicago is one of the top events every year. This years each of their children. Currently, Walk for PKD is September 26 at Busse Woods Forest Preserve. To learn more or to ARPKD is a relatively rare form of disease. dialysis and transplantation are support the walk, visit Photo: Polycystic Kidney Foundation PKD affecting one in 20,000 babies To learn more, visit www.pkd- the only treatments. There is cur- side, blood in urine, kidney stones, forced to depend on dialysis or a and can lead to death in the first or call 1-800-PKD-CURE. rently no cure for PKD. frequent urinary tract infections, transplant to live. month of life. Parents who carry Common side effects include heart problems and stroke. About PKD equally affects men, the ARPKD gene have a 25 percent high blood pressure, constant or 50 percent of people with PKD women and children—regardless chance of passing the disease on PolycyStic Kidney Foundation intermittent pain in the back and will develop kidney failure and be of age, race or ethnic origin. It does to each of their children.
  8. 8. One in 9 adults in the United States has chronic kidney disease (CKD) and many of them don’t even know it. You may have an increased risk for kidney disease if you have diabetes, high blood pressure, or a family history of kidney disease. Do you have or are you at risk for kidney disease? Learn more at ©2010 Abbott Laboratories Abbott Park, IL 60064 130-414714 July 2010 Printed in U.S.A.