How Education Can Improve the Outcomes of Patients with Chronic Kidney Disease 

Show Notes

Take a behind-the-scenes look into the world of DNA with real examples of our values in daily life. In this episode, Sandra M. Lauriat, MD, Nephrologist, and Director of CKD Education, talks about the importance of educating patients to make better choices and DNA’s groundbreaking kidney patient education program. 

What is Healthcare Literacy? 

DNA believes in encouraging patients to understand and find reliable information regarding their own health. We also believe in providing education that’s easy to understand and applicable to patients to improve the efficacy of health care plans and overall health. 

If a patient doesn’t understand a healthcare provider, a patient needs to gather, look and understand information because of the difficulty of our medical situation here in America. So DNA likes to help patients understand and find what’s reliable and suitable for them and their medical situation.

What Does Healthcare Literacy Include?

When a provider and patient come together to decide on treatment and nutritional options, an informed patient participates in putting together their comprehensive plan. Therefore, DNA prioritizes patient education because those involved in their healthcare are healthier, happier, and follow care plans more than those who aren’t invested in their health. 

How Does DNA Improve Healthcare Literacy? 

Providing a robust education program outside the treatment room on disease information, how to keep kidneys healthy, and what to do as their disease advances are all part of how DNA improves the education of our patients.

Internal Links and Resources 

Dallas Nephrology Associates website:
National Kidney Foundation website: 
National Institute of Health website:


Bri (00:00):

Dr. Lauriat, thank you so much for taking the time to join today. From what I understand, Dallas nephrology associates has really always prioritized patient care and training. It has really seemed like a big commitment for the team, but overall, why is patient education important from your perspective?

Dr. Lauriat (00:19):

Thanks, Bri. . Dallas nephrology has always emphasized the importance of patient education. When patients are educated, they’re healthier, they’re happier. They follow their care plans. And so as a healthcare provider, that’s a benefit to us as well as to the patient.

Bri (00:37):

I can imagine the more you’re educated, the more you feel like you’ve got some boundaries, right. You know, what decisions you can make and you know, what decisions you shouldn’t be making. So at least you have this box that’s, that’s better to operate in. Right. But I’m sure there’s a better medical term for the box that I’m talking about. And that’s the patient care plan. What is that?

Dr. Lauriat (00:58):

Yes. The care plan is really when the healthcare provider and the patient come together and decide what treatment options they want what perhaps nutritional requirements they may need. You know, it’s really a very comprehensive, big plan. And so when the patient knows what’s expected of them and understands that they’re more compliant, they’re more, they they follow that plan and if they don’t, then at least they know that box that they were, they, they were in. . why perhaps they’re having a complication or a problem.

Bri (01:31):

Well, there was something you had mentioned before and that there’s some patients who prioritize quality of life versus quantity of life. And so are those the types of conversations that are being had when you’re putting together there a care plan? Like what’s most important to them?

Dr. Lauriat (01:45):

Yes, so, absolutely. Exactly. Right. And so there are a lot of different aspects to a care plan . Into what a patient really wants and needs. And so it’s really important for us as healthcare providers to know that, you know, we have our own personal opinions of what we would like to, but that doesn’t often align or, you know, it may not align with the patient. And so we have to put ourselves out of that and into what the patient wants and needs.

Bri (02:12):

Well, and so are there other benefits to patient education outside of just the care plan?

Dr. Lauriat (02:17):

Yes. So you know, studies have shown that patients who follow their care plan or who educated, understand their disease process they ask questions. And so that question asking with the physician or the healthcare provider starts a dialogue. . And so some things that as a doctor, I might not know when they get educated and they ask a question, I then can answer perhaps fear or problem that they might have.

Bri (02:48):

. Because when you’re given in such important information, like when it, it revolves around your health, I can imagine my first thought is, well, I don’t know what I don’t know. So I don’t even know what questions to be asking you. And so do you feel like there’s that education element where you’re just trying to equip them to ask better questions of you?

Dr. Lauriat (03:09):

, actually it’s really interesting that when you give sort of bad news to patients or they hear something that they assume is sort of bad all the blue blood actually flows to the part of the brain, that’s our fight or flight. And none of it goes to the cortex or the part that makes us think. And so sometimes as the patient understands and gets that education, that they are able to make good decisions.

Bri (03:34):

And so is how is that educate? Like, what is the timeline of, of educate, right? Is it something that you’re having a conversation about in a first visit or, you know, how are you actually feeling like you’re educating them throughout the, the patient journey?

Dr. Lauriat (03:49):

Oh, so that’s a really good question. So it’s really layers. Patients need some basic information and as healthcare providers, we need to provide that information in the language that the patient understands. And so what do, I mean by language? It really is learning styles. So patients learn in many different ways. And for example some people learn through reading. Mm. And so I’m kind of that type of a person. I would like look at a manual and read a, my husband calls me a skimer cuz I kind of skim, but I really do read my husband’s a YouTuber. So he learns by looking in by by watching a video and then other people learn by actually doing something. And it’s sort of like when your dad taught you how to change a tire, so you really didn’t understand it until you actually went out and changed the tire.

Bri (04:40):

. I mean, I found out I was dyslexic. Luckily my parents helped get me tested early to be able to understand the best way for me to be able to learn. However, that’s not a benefit that everyone has. I can imagine you don’t get to ask a patient. So how do you best learn? And somebody says, well, I learn, you know, do they normally have an answer for that question? Or are you normally having to trial and error and, and show them a plethora of, of

Dr. Lauriat (05:04):

Different styles? . So another really good question. It’s really it’s, it’s a, it’s a feedback. So I’m watching the patient when I’m talking to them about, let’s say chronic kidney disease and I can tell pretty quickly if they understand what I’m talking about. And so from my perspective, I have to say, you know, I’m watching their body language and if I see signs that they’re not particularly catching on either they’re glazing over or they’ve got that big, big look

Bri (05:35):

Yes. Or they’re saying yes, multiple times, they’re like, yes, I totally understand what you’re talking about.

Dr. Lauriat (05:41):


Speaker 3 (05:42):

Right. At that

Dr. Lauriat (05:43):

Point we kind of back up. And so, you know, from a healthcare pers perspective, I always tell and teach that you should you know, watch the patient’s body language. And then if they’re not quite getting it, getting it, you know, ask them simply say, does that make sense? . And then if it, if you, even if they nod yes. Repeat it. . And repeat it in a simpler term. Most patients need to learn in about a sixth grade level, you know,

Bri (06:10):

I mean, I’ve joked with my friends many, a time that I can go into a doctor’s appointment and I can leave. And I’m, I feel like I completely understood what we talked about and we have a plan and then I, I leave and somebody starts asking me questions and I think I actually have blacked out. Right. Like you said, the blood leaves your face and all of a sudden you don’t remember what, what you’ve talked about. So I’m curious of from an education standpoint, what are some things outside that are happen outside of the patient room that you’re helping them, you know, that continuing that education outside of just being in the patient room.

Dr. Lauriat (06:44):

Right. So for, for us at Dallas nephrology, we have a really robust educational program. And it starts with a very basic chronic kidney disease class. It’s a group class that we hold. And it gives the patient just really basic information about what chronic kidney disease is how to keep their kidneys healthy what they need to do to, as the kidney disease, perhaps advances and that’s called our, our CKD and a basic group class. It’s a free class. It’s a wonderful class. . We also have, for our later stage, our later stage being more advanced kidney patients, a wonderful six part workshop session called my kidneys, my options, my life

Bri (07:35):

That’s fabulous. Well, and so, you know, you talked about a little bit of the different ways that people can learn, but what exactly is healthcare literacy, right? Like, is this a six part series or what does that mean to you? Healthcare literacy.

Dr. Lauriat (07:50):

So healthcare literacy is really important for patients to be able to gather information, be able to look at the information and see if it’s reliable or not. And then to understand the information. And unfortunately there’s a lot of illiteracy out there in the healthcare. I mean, think even as us, we’re pretty educated, right? How hard it is sometimes to make appointments, to go through insurance, to really understand our benefits. I mean, sometimes it’s just feels a very overwhelming. Yes. And so there’s a, there’s been a real push to help patients understand, gather important information, make sure it’s reliable and then to take action.

Bri (08:32):

I think I can imagine half of the battle there is you don’t wanna ask what seems like a stupid question, or I know that you’ve told me, maybe three times before, but I, I still don’t understand. I mean, it, it, that often doesn’t happen. I can imagine right. Where you’re trying to get to a point where a patient really you’re encouraging them to say, it’s if you’re asking me for the fourth time, like, I want you to actually understand it cuz I’ve given you the information. It’s just a matter of if you actually understand the information.

Dr. Lauriat (09:02):

Yes. And so I would say if you’re a patient and you’re not understanding your treatment plan or your care plan or some aspect of the, of the visit simply just ask, you have to ask questions. It’s not remember what your mom said. No question is a stupid question. That’s really true. You just have to ask until you understand it and it’s, and if your doctor or the, or the nurse, or whoever is not explaining it to you in that way that you understand, you know, you can also, you can also say, can you draw me a picture or, ask them, is there another place where I can get more information it’s really, really important that patients get reliable information? .

Bri (09:52):

Google can be your biggest nightmare. Well, so asking questions, I’m sure the biggest tip, but what are some other best practices for getting the most out of patient, your patient education?

Dr. Lauriat (10:05):

You mean from the, from the patient perspective?

Bri (10:07):

From their perspective.

Dr. Lauriat (10:09):

I think it’s really important that they learn more. So again, whether they come to one of our classes or they get on websites that are reliable that’s really the most important part, but it also needs to take action. . So it’s one thing to know that you have high blood pressure. It’s one thing to know that you have a kidney disease related to the high blood pressure, but the next step is what are you gonna do about it? So it’s also important to make sure you understand what the treatment is. When you go to your visit, you know, I’ve got this chronic kidney disease, I’ve got high blood pressure. So what’s my goals. You know, what are my treatment options? It’s also important too, that if you have problems or complications or for some reason cannot follow the treatment plan that you call your doctor or the new nurse, don’t wait until your next visit. But call your doctor say, I’m having a problem. This, this medicine’s too expensive. I’m having a side effect. So staying involved is just really important. It’s your body. We can only give you advice. So you need to take the lead.

Bri (11:13):

Well, and I can imagine when you mention reliable source, lot of patients have, like you mentioned a customed care plan, so everyone’s is different. However, you can go online and there is such a sense of community, right? You’ve got some of these workshops where people are sitting together and going through this education journey together, however, each of their care plans may be completely different. How do you, you know, I don’t know if combat is the right word, but comparing, you know, the beauty of community, but there’s also, that it can start to impact patient’s care plan when they start to ask, well, what are you doing? What’s working for you, right? When in, you know, as a doctor, I can imagine you’re wanting to make sure they stick to what you have discussed with them.

Dr. Lauriat (11:57):

Well, you know, I absolutely love it when patients come to me and say, I, you know, I’ve got this new vitamin, my best friend is using it. She feels great. Can I take it? And so it’s . I mean, it’s to gather information from horses, but always check with your doctor about whether or not that particular recommendation from your friend or family is, is a good one for you because everyone is so super unique. We all are so different. What works for me may not work for you.

Bri (12:27):

I understand that Dallas nephrology associates also known as DNA has had their own patient education program. And I think you touched on this for patients with chronic kidney disease. What’s been your involvement in the program over the years?

Dr. Lauriat (12:41):

Well, I was I was really going to be a teacher before I was a doctor. I really love teaching. And so my company knew this and in 2014 it was, they came to me and said they wanted to expand the education program. And so I did some research on what teaching and learning should, should look like and then develop this this program, the six part program, my kidneys, my options, my life. And since 2015, we’ve done over and thousand of these workshops. Oh, wow. With thousands of patients and extremely successful in improving patient lives. It’s really, really exciting.

Bri (13:27):

So I would love to hear more about what goes into this six part series.

Dr. Lauriat (13:32):

So there’s six current topics. And the patient will come in to visit the educator. So we have trained doctors who do these educational sessions. And the patient comes in, it’s a one-on-one visit. And during the visit, they see the video video on that particular topic, let’s say it’s transplant. So they’re coming in to learn more out transplant. So they see a video on transplant, they get printed materials about transplant and in those printed materials, we give them a specific resource list, all about transplant. And then they have a 20 minute visit with a doctor, this educator doctor, and it’s all about transplant. So it’s kind of the, the formula for the, the . The workshops works really well cause we’re hitting all those different learning styles. And patients are able to ask questions. It’s patients absolutely love it. We collect data about the workshops and over 98% of patients would run, recommend it to, to another, another patient.

Bri (14:40):

I was gonna say, if you’ve done 7,000, I can imagine that just informs your own education of what you want to relay back to patients. Is there anything, you know, that you’ve especially learned by doing this six part series through these programs and the data you’ve collected?

Dr. Lauriat (14:55):

Yes. It’s really been amazing that the patients don’t know as much as we assume as doctors. No. And so patients love to have that individual tension on one specific topic. We collected data that shows that patients are healthier, that if they have to go on to dialysis, that they spend less time in the hospital and who wants to be in the hospital, right? Yes. You’re away from your family. You’re away from your job, your friends. Your life. And so they spend less time in the hospital. They have less, which are these tubes that we use for dialysis and more patients choose to do dialysis at home, which is a huge benefit.

Bri (15:40):

That’s data that you’ve learned, from being able to do these series.

Dr. Lauriat (15:46):

We actually did a poster, an abstract at the American society of neph, a meeting in 2019. It showed all our great data. It’s been, it’s just been amazing and patients love it. The educator doctors love it.

Bri (16:00):

You also mentioned that there’s some different resources that you will include, you know, specifically about transplant, but I can imagine there, you know, for each topic there’s specific resources, what are some reliable sources that you recommend?

Dr. Lauriat (16:14):

So number one is to talk to your doctor. All the doctors at DNA are board certified in nephrology. So we’re really experts at kidney disease. Second is to look at our website. We have some wonderful, wonderful resources on our website. And then I love the NKF national kidney foundation has some really simple, easy to understand materials. Of course there’s some federal resources and national Institute of health at NIH also has some great resources.

Bri (16:51):

That is fabulous. Well, and I wanna make sure, did you talk about all the different aspects of data, because I think that’s such an important piece that people need to understand that you’re not only have done a ton of research and collected a ton of data before you even released any, you know, any of these programs, but through running it over the course of years and relaying it to 7,000 patients, is there any other data that we haven’t talked about yet that y’all also collected? Like what were some of, you know, in the poster? What were some of those statistics?

Dr. Lauriat (17:24):

So the ones about hospitalization, so less hospitalizations, fewer of those tubes, the catheters more dialysis at home. And then the other one that wasn’t in the poster, but we’ve just recently collected was that more patients who get educated through our program will be on the transplant list. And so that’s huge. Another really huge, . Huge impact. You know, patients are healthier, they’re happier, they’re more satisfied with their healthcare plan. And so our patient satisfaction scores are really good because of the education as well.

Bri (18:00):

And do they feel that that in enhances the confidence of the success of a transplant?

Dr. Lauriat (18:05):

I think they definitely are more prepared. They’re more prepared either if they have to go into dialysis or if they get transplanted. For sure.

Bri (18:13):

Knowledge is power knowledge and is power. So what makes patient education through Dallas nephrology associates different than what they may get elsewhere?

Dr. Lauriat (18:30):

I’ve been with my company almost 23 years, so . I’m pretty biased.

Bri (18:34):

You’ve been with DNA for 23 years.

Dr. Lauriat (18:36):

I’ve been there a long time. I think unfortunately other practices may not have the resources and the ability to do the type of education that we can do. Again, we hit all those different learning styles. Patients get a one on one about a specific topic. I am a bit biased I was part of the creation of it. And I think other practices and other, other physicians outside of DNA may not have that luxury, that resource

Bri (19:08):

That we, can imagine it’s important that you’re placing this focus on meeting them where they’re at being able to understand this is how you learn best. So we’re gonna provide education and this style specifically to help you make sure that you understand it, because like you said, that informs such better decisions, right?

Dr. Lauriat (19:27):

Better decisions. They understand what is a important to do and what not to do. And we reinforce it. So it’s just a reinforcement reinforcement. We all need a little bit of encouragement and reinforcement.

Bri (19:40):

Absolutely. Well, in closing here, what is some of your best advice that you can give to a patient in order for them to take better care of themselves through this through are the educational opportunities?

Dr. Lauriat (19:53):

Well, I think first of all, and we mentioned it, it’s just to really ask questions. If you don’t understand what your plan is, that care plan, make sure you ask, know that you probably don’t need all the information at one time, you can get little bits and pieces as you go along. If you should, it have a complication or a problem, don’t wait till your next visit. You know, call your doctor. We really do want to know if you’re having a problem. We don’t wanna wait, you know, two or three months and see that you couldn’t afford your medication. And therefore your blood pressure is still high.

Bri (20:32):

I think is one of the things that I didn’t realize, just how important of an aspect it was to your adult life. Like being able to ask questions is really the most important part. And the more you’re informed, the better your questions are.

Dr. Lauriat (20:47):


Bri (20:49):

Well, I am so grateful that we got to talk about this because I think the program that you developed is so critically important, clearly shown through just the amount of patients that you’ve had. I can imagine you’re expecting a long future of that as we continue from here.

Dr. Lauriat (21:03):

Yes. I’m excited. See what the future holds.

Bri (21:06):

And I’m sure it continues to inform the program. That’s fantastic. Thank you so much.


Dallas Nephrology Associates’ (DNA) podcast series, Let’s Talk About Kidneys, is provided for general information purposes only and does not replace the need to talk with a healthcare professional about your unique situation, care and options. Our goal is to provide you with as much information as possible so you can be as informed as possible. Reference to any specific product, service, entity or organization does not constitute an endorsement or recommendation by DNA. The views expressed by guests are their own and their appearance on the program does not imply an endorsement of them or any entity or organization they represent. The views and opinions expressed by DNA employees, contractors or guests are their own and do not necessarily reflect the views of DNA or any of its representatives. Some of the resources identified in the podcast are links to other websites. These other websites may have differing privacy policies from those of DNA.  Please be aware that the Internet sites available through these links and the material that you may find there are not under the control of DNA. DNA shall have no responsibility for the accuracy, legality or content of the external site or subsequent links. Contact the external site for answers to questions regarding its content. The resources included or referenced in the podcasts and on the website are provided simply as a service.  DNA does not recommend, approve, or endorse any of the content at the linked site(s).  The content provided on this website and in the podcasts is not medical advice and should not be used to evaluate, diagnose, treat, or correct any medical condition. The content is solely intended to educate users regarding chronic kidney disease, end-stage renal disease (“ESRD”), end-stage kidney disease (“ESKD”) and related conditions, and ESRD/ESKD treatment options.  None of the information provided on this website or referenced in the podcasts is a substitute for contacting a healthcare professional.