In the 21st century, chronic diseases such as chronic kidney disease (CKD) and cardiovascular disease due to diabetes and hypertension have replaced infectious diseases and become the leading cause of mortality, morbidity and work loss both in the western world and developing economies.  The highest rates are in the rural south especially in the underserved areas of Appalachia boarding Virginia, Kentucky, Tennessee and West Virginia.  In Virginia, kidney disease is most prevalent in rural counties where Medicaid expenses can represent as much as 15% of their annual budget.

Chronic Kidney Disease (CKD) develops when the kidneys begin to lose most of their ability to remove waste and maintain fluid and chemical balances in the body.  CKD can progress quickly or take many years to develop.  If CKD, goes untreated, it can result in kidney failure, also known as End Stage Kidney Disease (ESKD).  ESKD is treated by lifelong dialysis or kidney transplant.  The burden of chronic kidney disease currently affects over 26 million Americans. 

Risk factors for chronic kidney disease include diabetes, high blood pressure, obesity, lower socioeconomic status, minority populations, and having a family history of kidney disease.  By controlling diabetes and hypertension, a person's kidney damage can be slowed or even stopped if they can reach goal blood pressure and blood sugar levels so that it does not progress to ESKD.  Over 60 million Americans have hypertension with only a small portion who are adequately treated.

Dr. Ross Isaacs is a nephrologist who specializes in the prevention of chronic kidney disease in high risk and underserved populations.  Dr. Isaacs provides nephrology consults via telemedicine in addition to hosting free quarterly onsite nephrology clinics to assist in battling chronic kidney disease often caused by hypertension and diabetes.  For more information about these clinics, please contact the Health Wagon.