Arthur Franke, PhD September 18, 2008

1. Arthur Franke, PhD September 18, 2008

2. Our Mission: To prevent kidney disease and improve the quality of life for those living with it. • Our Guiding Principles: • Striving to prevent chronic kidney disease (CKD) and its leading causes; • diabetes and hypertension • Advocating for people living with and at risk of CKD • Educating the public about CKD, diabetes, hypertension and obesity • Promoting quality of care for people with CKD, diabetes and hypertension • Promoting organ and tissue donation • Supporting research of CKD • Pursuing funding in support of our mission

3. Chronic Kidney Disease • Chronic Kidney Disease (CKD) is defined as permanent kidney damage, or decreased level of kidney function for 3 months or more. • If left untreated, CKD can lead to total kidney failure, requiring dialysis or a kidney transplant.

4. Why We Started The Program • One in 8 adults ages 20+ has CKD, and most don’t know it. • The leading causes are diabetes and hypertension, in 71% of all cases. • Healthy lifestyle changes are key to prevention. Glomerulonephritis 7% Other Hypertension 22% 29% 42% Diabetes US Renal Data System, 2006.

5. CKD is an Epidemic • The annual rate of new cases of chronic kidney failure (CKF) in MI is higher than the national average. • CKF is expected to double between 2000-2010. Source:JL Xue, et al. J Am Soc Nephrol 12:2753–2758, 2001.

6. Minorities Have Significantly Higher Risk • African Americans are: • much more likely to be affected by diabetes and high blood pressure than whites. • 4.5 times more likely to develop kidney failure than whites. • comprise 14% of the population in MI, but 47% of the dialysis population. • One in 3 children born in the US in 2000 will develop diabetes. • The number jumps to 2 of 5 for African American and Hispanics. Source: NAACP, NKF,2002; CDC 2005

7. Distribution of Patient Counts & Costs in the CKD, CHF, DM, & ESRD Populations Populations estimated from the 5 percent Medicare sample, & include patients surviving the entire cohort year (1992, 2002) with Medicare as primary payor, plus period prevalent ESRD patients for 1993 & 2003. Diagnoses determined from claims in 1992 & 2002. Patients with ESRD in the 5 percent sample are excluded, as they are counted in the ESRD population. Costs are for the second year of the two-year period. Source: USRDS Coordinating Center, ADR 2005 (Allen Collins)

8. Keys to Kidney Health Worksite Wellness Goals • The NKFM has a free resource guide designed to: • Raise awareness about chronic kidney disease. • Address high blood pressure and diabetes. • Increase knowledge and improve the health behaviors of partners’ employees.

9. Topics Physical Activity – Nutrition / Weight Management – Diabetes – High BP - CKD Options For companies large and small, a key to controlling spiraling health costs is to minimize the number of employees who suffer from chronic disease and symptoms. Program Intensities Awareness Behavioral Change Environmental Support Program Mix Presentations, Resource Guide, Educational Info, Other Materials, PATH Training

10. Keys to Kidney Health Objectives • Show how lifestyle changes can prevent chronic disease. • Provide tools to assess health status and guide lifestyle improvements. • Offer free programs to encourage successful management of ongoing health conditions. • Create opportunities to set, achieve, and sustain healthy life-style goals. • Demonstrate health benefits, cost-effectiveness, and good return on investment.

11. Personal Action Toward Health (PATH) www.MIPATH.org • Community-based workshops- to provide the skills and tools • needed by people living with chronic health conditions, and their caregivers • Evidence-based outcomes • - ROI – annual cost savings ~$260 per participant • Developed at Stanford University • Uses strategies to enhance self-efficacy by learning how to: • - Deal with the challenges of not feeling well • - Overcome stress and relax • - Increase level of energy • - Handle everyday activities more easily • - Stay Independent • - Peers helping each other • - Changes in health care utilization

12. Employee Awareness: Facts about CKD and Its Causes • Topics included in Awareness Presentation • Are you at risk for chronic kidney disease? • Diabetes and hypertension – what is the connection to CKD? • How to make healthy food choices • How to be more physically active • How to get blood pressure to goal • Facts about pre-diabetes • Getting the very best care to manage diabetes • Information on organ donation and transplantation • Planning for the future

13. CD-ROM Contents • 101 Wellness Ideas for the Workplace • Healthy Snacks and Beverages List • NHLBI Educational Materials • Food Labels Educational Tool • Food Choice Worksheet • Designing Healthy Environments Assessment Tool • Sample Newsletter Articles, promotional flyers, and emails • Are You At Risk? Brochure • My Healthy Living Action Plan Worksheets • And much More…

14. NKFM Program Components • Presentations on CKD, Diabetes and Hypertension • MI Steps Up! Designing Healthy Environments Assessment Tool • Sponsor Chronic Disease Self Management Training (PATH) • Form walking teams to participate in Walk Events • Place sample newsletter article(s) in your company’s publication • Provide diabetes and hypertension resources • Meet with at-risk affinity groups within your company • Share success stories with employees

15. Inflam-matory markers High trigly-cerides High LDL-C Abdominal Obesity Elevated Fasting Glucose Insulin Resistance Low HDL-C Cardio-Metabolic-Chronic Kidney Disease Risk Factors Classic Risk Factors Emerging Risk Factors High blood pressure TYPE 1 Diabetes TYPE 2 Diabetes Cardiovascular Disease Smoking Underlined = Type 2 Diabetes Risk Factor Low GFR, High micro- albumineria Chronic Kidney Disease Sources / Sanofi Aventis, Theuma P et al. Curr. Diab. Rep. 2003;3:248-254, Lee Y-H et al. Curr Diab. Rep. 2005;5:70-75

16. Questions For more information contact: Laurie Gustafson, MA (734)222-9800 x246 lgustafson@nkfm.org