New NKF President Beth Piraino, MD, to Focus on Disease Awareness

Coleman, Matthew

doi: 10.1097/01.NEP.0000426010.23708.db
The Clinical Interview

As President of the National Kidney Foundation (NKF), Beth Piraino, MD, Professor of Medicine and Associate Dean of Admissions and Financial Aid at the University of Pittsburgh School of Medicine, is setting her sights on increasing kidney disease awareness, consistent with the foundation's growing emphasis on the at-risk population. Dr. Piraino, who succeeds Immediate Past President Lynda A. Szczech, MD, MSCE, hopes that through an awareness campaign, those with risk factors for kidney disease may learn valuable information that will inspire them to seek a diagnosis, or, even better, to make changes to prevent the condition. Nephrology Times spoke with Dr. Piraino about empowering patients to take the best care of themselves.

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What do you plan to accomplish as President of the National Kidney Foundation?

Dr. Piraino: The focus of the National Kidney Foundation is now shifting a bit to people who are at risk for developing kidney disease. We're very interested in helping people identify themselves as being at risk and maybe even already having early kidney disease, which is where you can actually make an impact and do something to prevent it from progressing, or at least slow the progression to decrease the numbers of people who have this really devastating illness.

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What steps are needed to meet this objective?

Dr. Piraino: I think we need to make people much more aware. There's going to be an awareness campaign, and all the little details of this haven't been exactly worked out, but we definitely are well on our way in beginning to develop this. One of the things that is in the works and has already started is making little videos of people who actually have kidney disease, and maybe they found out all of a sudden—just came to the emergency room, were sick, and then all of a sudden somebody was talking to them about dialysis, and they had no idea that they had kidney disease. Maybe when people hear these vignettes, they will actually think, ‘Hmm, I wonder if I have kidney disease, and maybe I will go and get it checked.’ Really it's a matter of getting a simple blood test and a simple urine test to see if you already have disease. [It's also important to make] sure that people who do not have disease [but] have high blood pressure, diabetes, a family history of these, or a family history of kidney disease understand that they are at increased risk [of] getting kidney disease so that they can take action themselves to hopefully not develop kidney disease.

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Why are these goals important to you and to the NKF?

Dr. Piraino: I spent my whole career, 30 some years already, with kidney disease, seeing patients day in and day out, and [the disease] has such a terrible impact on people's lives. Some people deal very well with it, and then other people don't deal so well with it, but there's no question that it's really a fairly devastating disease, and it certainly shortens people's lives. I'm very committed to trying to prevent that from happening to people. As years went on, I myself developed high blood pressure, so it became a little personal there. I realize that people have to take action themselves. Health care providers can only do so much. Most of what one has to do is within one's own hands, but if you don't know you need to do it, then you may not be so committed to doing it.

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How has your work in academia and as a clinician informed your approach to this new role with the National Kidney Foundation?

Dr. Piraino: I do see myself very much as a teacher, not just as a physician. The word for doctor comes from the word teacher. Certainly as a nephrologist, a lot of what I do is teaching my patients, so I'm not just talking about teaching medical students and trainees. If I reflect on the time I spend with my patients, so much of it is involved with explaining to them what their disease is and what needs to be done, and outlining a plan. The plan involves the patient taking charge, so to speak, so the patient is really at the center of the process. We all talk about patient-centered care now, but I've been a believer in that for a long, long time. The patient isn't going to do what you're recommending unless the patient is convinced that it is essential for his or her welfare in the future. And even then people make choices sometimes that aren't in their best interest, but that's up to people. They have to make these decisions themselves.

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What are you most looking forward to in your term as President of the NKF?

Dr. Piraino: It is an exciting time at the National Kidney Foundation. I think the Board is very, very strong. This is an opportunity to really move the NKF forward in making some partnerships, maybe with health care organizations, to try to really have an impact on the population in the United States, particularly all those people who are at high risk, and there are lots of them—millions, basically.

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