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“I treat patients all along the renal disease continuum,” observes Paul Panebianco, DO, Virtua West Jersey section chief, nephrology. “My job is to keep them from progressing to where cardiovascular, endocrine and nervous system damage can occur – including a complete loss of kidney function.”
Dr. Panebianco says: “The best time to successfully slow disease progression is early in the process. We know that individuals with diabetes and hypertension are a cohort often affected with renal failure, so rigorous kidney disease monitoring is critical for this group.”
If kidney function is found to be compromised and intervention required, a team approach with a physician, nurse educator and dietitian helps patients effectively control their glucose levels, cholesterol levels and blood pressure with a combination of education and clinical care.
With chronic kidney disease, the battle to control a patient’s creatinine levels often fails. At the point where hemodialysis, peritoneal dialysis or transplantation becomes a reality, it is critical that “good care of kidney disease patients in the period before renal replacement therapy is implemented to reduce the substantial morbidity and mortality associated with ESRD (end-stage renal disease).”*
This care includes stabilizing metabolic function, preserving any remaining kidney function and, if a patient is undergoing hemodialysis, creating an access, which often is an arteriovenous fistula or graft, well in advance of the actual start date of dialysis.
*NIDDK, “Healthy People 2010 Objectives: Chronic Kidney Disease Draft Chapter.