Listening to the Whisper: Rethinking Kidney Care at the University of Michigan

In a conversation on The Kidney Corner, transplant recipient and advocate Craig Merritt sat down with nephrologist Dr. Julie Wright Nunes to explore a persistent challenge in kidney care: too many patients don’t know they’re sick until it’s almost too late.

For Dr. Nunes, a physician-researcher at the University of Michigan, the issue is both clinical and systemic. Kidney disease is often labeled “silent,” but Merritt offers a more fitting description: it “whispers.” Subtle symptoms—fatigue, swelling, high blood pressure—are easy to overlook, allowing the disease to progress unnoticed until patients “crash” into late-stage care and require dialysis.

That moment, Dr. Wright argues, is where the system has already failed.

Much of her work focuses on preventing that outcome through earlier detection, better communication, and stronger patient education. Simple screening tools—blood tests for kidney function and urine tests for protein—can identify disease long before symptoms escalate. Yet awareness and routine testing still lag, especially among high-risk populations.

The conversation also sheds light on the realities of treatment. Dialysis, while lifesaving, cannot fully replace the constant work of healthy kidneys. Patients often endure fatigue, cramping, and dramatic physical shifts—an experience Merritt relates to running a “mini-marathon” several times a week.

Underlying all of this is a central theme: partnership.

Dr. Wright emphasizes that patients must be active participants in their care—asking questions, preparing for visits, and advocating for themselves. At the same time, clinicians and health systems must do more to meet patients earlier, with clearer information and better support.

Advancing kidney care isn’t just about new treatments, it’s about listening sooner, educating better, and building systems that don’t wait for the whisper to become a crisis.

Watch the podcast here