I enjoyed Dr. Gardiner’s talk on Friday. I learned a great deal about chronic kidney disease. For example, I was unaware that it is a silent disease and how big of an issue it is. I wasn’t surprised to hear that minorities are disproportionately affected. We have learned in this class that minorities have lower SES which leads to lower health literacy, lower access to care, and ultimately higher rates of chronic disease. I think a possible solution to this would be to have social workers and/or nurses have practices in areas with the highest rates of obesity, diabetes, hypertension, etc, who go into peoples’ homes and educate them on what health behaviors to change and how to take better care of themselves. Something that shocked me was the number of health care professionals who did not know what their hospital’s policy on kidney transplantation for obese individuals was. I feel like knowledge of this information would be vital because a doctor could be putting a patient’s health at risk if a transplant was done on an individual who did not meet the proper criteria. The Obesity paradox was something else I didn’t know about. Being on obese is actually helpful for individuals on dialysis but these individuals are told to lose weight before getting a transplant. Losing weight is hard because dialysis really makes you feel terrible. Also, I think it’s kind of lazy of health care providers to tell individuals to lose weight but not give them any resources to help them do so. Losing weight is extremely hard and requires a plan specifically designed for the individual. Finally I noticed that the studies Dr. Gardiner discussed had a significant amount of limitations. The sample sizes were small, bias was not controlled for, etc. This made me realize how hard it is to get accurate data. By the end of the talk I felt that the U.S. health care system needs better coordination of care and that hospitals really need to freshen up on their knowledge of their policies. Europe, and Spain in particular, seem to not only be doing transplants better but they are doing healthcare better. I think the U.S. needs to look at Europe and tweak its system based on what European policies would have the best chance of success in the U.S. given our population and current/past health care policies.