San Antonio Express-News (Sunday)
Texas Kidney Foundation presses fight against disease
Free at-home health screening kits are available to 10,000 Texans
When it comes to solving a problem, Tiffany Jones-Smith can be relentless. Especially when it’s something that affects her family.
It’s that tenacity and resolve that helped her go from volunteer to board member to executive director of San Antonio-based Texas Kidney Foundation.
She first got involved because of how many of her own family members had chronic kidney disease. Nine of them have died because of it.
Her brother was training for a triathlon when he was diagnosed with it. Within 18 months, he nearly died three times.
Then he was matched with a living kidney donor.
Jones-Smith decided that one of the best ways to tackle kidney disease is better screening.
So she searched and found an easy, costeffective way to check patients’ kidney function and prevent disease.
She partnered with an Israel-based technology company Healthy.io for a new initiative to help detect undiagnosed chronic kidney disease by sending Texans free at-home kidney screening kits, guided by a smartphone.
The kits will be sent on May 17 to the first 10,000 people who request it online at SilentButDeadly.org.
When Jones-Smith took the reins in 2017, the organization had only enough funding to keep the lights on for two weeks. So she got to work writing grants, partnering with local medical providers and reading all the research she could on the disease.
“I was literally praying through it every day,” she recalled those first few weeks. “I realized this can’t be a one-woman team.”
She started partnerships with renal dietitians, behavioral therapists and other medical providers who wanted to help kidney patients in the community maintain a high quality of life.
Getting people to go to the doctor can be difficult under the current U.S. health care system — one that is often more reactive than proactive to illness and is expensive, even for people with health insurance.
She knew that access to affordable care would be a barrier for many San Antonians so she found a local doctor doing labs and an office visit for $100. And then she got the cost down to $50.
“I wanted it so that a waitress can work one night and with her tips, get her lab work done. I wanted it to be that cheap,” she said.
Before long, the foundation grew to become the single biggest screener of kidney disease in Texas.
An estimated 37 million Americans — 1 in 7 adults — have chronic kidney disease, but San Antonio residents have a much higher risk because of the high rates of diabetes, high blood pressure and heart disease among Black and Latino residents in the community.
CKD often goes unnoticed until it’s too late. Patients develop end-stage renal disease when the damage to their kidneys reaches an advanced state and the body is no longer able to clean its own blood.
This is when dialysis or an organ transplant is needed to survive.
Dr. Kumar Sharma, chief of nephrology at UT Health San Antonio, has seen the devastating effects of endstage renal disease on patients.
His life’s work includes writing the major theory that guides research and current therapeutics. Sharma recently identified pathways by which diabetes causes disease in kidney cells and patients.
“We’re at a disadvantage as many people are skipping doctors visits or don’t get blood tests because of the pandemic. COVID itself can cause acute kidney disease,”
Sharma said. “It’s really a tragic situation that can be avoided.”
Promoting early intervention is a problem when most people with the disease don’t have symptoms. That’s why early screenings are vital to preventing the onset of disease.
“It’s giving people the opportunity to take care of their life and their health. What you don’t know you aren’t gonna do anything about,” said Anil Mangla, board chairman of the Texas Kidney Foundation and lead epidemiologist at the public health department in Washington, D.C.
Mangla speaks from personal experience. He didn’t know his own kidneys were failing.
By the time he found out he had kidney disease, he was in his 40s and needed to go to a dialysis center for treatment at a cost of about $2,000 a month.
He went to the center for eight years as he waited on a transplant list. Three times a week, he was hooked up to a machine that filtered his blood of toxins.
“My life revolved around those three days of dialysis. Now I know it shouldn’t be that way,” he said.
Mangla says he wants to help people avoid ever getting irreversible kidney damage so they won’t need dialysis or a transplant.
To accomplish this goal requires the foundation to take a proactive approach, which means realizing that while the Healthy.io tests work for many, it won’t work for all residents in need.
Jones-Smith said those who don’t have a smartphone can still schedule an appointment for free in-person kidney screening at the foundation’s office on 4204 Gardendale.
The foundation will have health care personnel at Sacred Heart Church, 2114 W. Houston St., from 8 a.m. to 3 p.m. today, offering free, 15minute kidney function screenings that also check for underlying health conditions such as high blood pressure, diabetes and prediabetes.
Mangla said there’s another reason why people should pay attention to kidney health: Conservative estimates show the federal government pays more than $81 billion in Medicare costs each year for chronic kidney disease patients.