Annual Report - National Kidney Foundation

Annual Report - National Kidney Foundation

30 East 33rd Street New York, NY 10016 800.622.9010 www.kidney.org ANNUAL REPORT © 2007 National Kidney Foundation, Inc. All rights reserved. 03-25-...

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30 East 33rd Street New York, NY 10016 800.622.9010 www.kidney.org

ANNUAL REPORT © 2007 National Kidney Foundation, Inc. All rights reserved.

03-25-2006

2006

TABLE OF CONTENTS A MESSAGE FROM OUR LEADERS

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UP FRONT

5

PUBLIC EDUCATION FOCUS ON: CAROLYN PRICE

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PATIENT SERVICES FOCUS ON: MARY WENDT

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ORGAN AND TISSUE DONATION FOCUS ON: EMILY BIONDI

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PROFESSIONAL EDUCATION FOCUS ON: DR. LESLIE SPRY

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ADVOCACY FOCUS ON: JIM MCDERMOTT

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RESEARCH FOCUS ON: DR. ROBYN CUNARD

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FUNDRAISING FOCUS ON: ROY MALKIN

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CORPORATE PARTNERS

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OUR SUPPORTERS

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LEADERSHIP & AFFILIATES

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REPORT OF INDEPENDENT AUDITORS

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NOTES

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COMBINED FINANCIAL STATEMENTS

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EDITORIAL DIRECTOR: Ellie Schlam EDITOR: Jamie Biegeleisen GRAPHIC DESIGN: Silvia Avramov COVER PHOTOGRAPHS: Erica Berger, Eric Miller, Allison Michael Orenstein CONTRIBUTING WRITERS: Christina Cheakalos, Geraldine Connors, Patricia O’Connor, Bryan Van Steenbergen, Kerry Willis

Photo: Acey Harper

FROM OUR LEADERS Every day, the National Kidney Foundation (NKF) is achieving life-saving results in cities and communities across the U.S. One day, it’s the mom who found out at our free screening that she had early signs of kidney disease, and who is now taking steps to prevent further complications. The next day it’s a kidney transplant recipient who won a gold medal at the Foundation’s Olympic-style U.S. Transplant Games. The next week, it’s the longtime dialysis patient who has newfound courage to speak up and visit his local congressman to advocate for legislation that increases his Medicare benefits, thanks to the Foundation’s patient empowerment initiative. These are the kind of results that truly define the NKF. Our visual identity was solidified with consistent use of our new logo, and we moved into the next phase of our rebranding initiative. This included taking stock of the truths about the NKF brand, its benefits and personality, and articulating the brand vision that will guide us today and into the future. This process culminated with the development of a brand positioning that signifies what we stand for, and focused all of our efforts. The new positioning statement is life-saving results today, and we are delivering those results in a way that differentiates NKF from its competition—with hope, empowerment and information. The positioning process pushed us to take a long, hard look at who we are and where we are headed. As a result, we embarked upon a major strategic planning initiative. We identified our key goals and set measurable objectives and strategies to help us reach them. These goals, which support our new positioning, include empowering patients and families, and improving treatment for those at risk and those who are already living with kidney disease. Through signature Foundation programs such as the Olympic-style U.S. Transplant Games, our ongoing “People Like Us” patient empowerment initiative, the Kidney Early Evaluation Program (KEEP)™ and Kidney Disease Outcomes Quality Initiative (KDOQI)™ clinical practice guideline development process, the NKF is delivering life-saving results to our key constituents—those at risk, patients, organ donors, the medical community and our supporters. As you read through this report, you’ll see exactly how the National Kidney Foundation is combining tangible results with a caring, human touch that is inspiring positive action on so many fronts.

John Davis, CEO

David G. Warnock, MD

“...THE NKF IS DELIVERING LIFE-SAVING RESULTS TO OUR KEY CONSTITUENTS—THOSE AT RISK, PATIENTS, ORGAN DONORS, THE MEDICAL COMMUNITY AND OUR SUPPORTERS.”

Chuck Fruit, Chairman

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UP FRON

REACHING OUT... 5,000,000

PAGE VIEWS ON OUR WEB SITE, WWW.KIDNEY.ORG

38,000 VOLUNTEERS NATIONWIDE $2,400,000 SPENT ON RESEARCH ON CHRONIC KIDNEY DISEASE

22,000 PEOPLE RECEIVED FREE

SCREENINGS FOR KIDNEY DISEASE

47,500 CONSTITUENT COUNCIL MEMBERS 265,529,182 TOTAL MEDIA IMPRESSIONS 342,000 READERS OF QUARTERLY

FAMILY FOCUS NEWSPAPER FOR DIALYSIS PATIENTS, THEIR FAMILY MEMBERS AND HEALTH CARE PROFESSIONALS

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UP FRONT BURL OSBORNE Burl Osborne approaches membership on the National Kidney Foundation Board of Directors as he does most everything else in life: with a journalist’s scrutinizing eye. In the five years since he retired as CEO of The Dallas Morning News, Osborne has accepted posts on several boards, which currently include that of chairman of The Associated Press. His standards are high, so he chooses his commitments very carefully. To the 69-year-old Osborne, the NKF was a natural choice. Not only does he believe

the organization does an admirable job, Osborne also happens to be a two-time kidney transplant recipient. His mother donated the first in 1966; the second came from his brother in 1994. “On Halloween, to be exact,” he recalls, laughing. Osborne says he is “particularly pleased” with the NKF’s KEEP education and screening program. “I’m most drawn to patientcentered activities,” says Osborne, who lives in Dallas. “The most important thing we must do is act responsibly and make sure that what we do is credible, that we are an advocate for patients. Whether they need treatment or transplants, or both, our role is to make sure they get whatever it is they need to live quality lives.”

Photo: Eric Miller

2006 U.S. TRANSPLANT GAMES The 2006 U. S. Transplant Games, presented by the National Kidney Foundation, was an Olympicstyle event for recipients of life-saving organ transplants. The Games represented the largest-ever gathering of transplant recipients, donor families, living donors and transplant professionals. While showcasing the success of transplantation, the event called attention to the great need for organ donors and honored those who made it all possible—the living donors and the families of organ and tissue donors.

Photos: Erica Berger

DONOR MOM MEETS RECIPIENT OF DAUGHTER’S KIDNEY AT U.S. TRANSPLANT GAMES Debbie Waddell was a 47-year-old mother and grandmother when she suffered multiple brain aneurisms. “Donating her organs, which is what Debbie wanted, changed my life,” says Meyers, who works at a hospital coffee bar. “There isn’t anything I won’t do to promote organ donation. I’ll shout it from rooftops. I miss my daughter every single day, but knowing that her organs are helping others’ live feels right.”

YOUR DONATION DOLLAR 8.8%

MANAGEMENT & GENERAL

9.0%

FUNDRAISING

7.3% RESEARCH Photo left to right: Tim Bell, donor’s oldest son; Carrie Conley, kidney recipient; Darrel Conley, Carrie’s husband; Linda Meyers, donor’s mother.

17.0% PUBLIC HEALTH EDUCATION

14.0%

COMMUNITY SERVICE

24.4%

19.5% PROFESSIONAL EDUCATION

PATIENT SERVICES

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When Carrie Conley met Linda Meyers for the first time in a Louisville hotel lobby, she did something that brought tears to both their eyes. “I placed Linda’s hand where her daughter’s kidney was located,” says Conley, a retired teacher who received a life-saving kidney transplant on Mother’s Day 2004. The two women had communicated through letters and a phone call, but hadn’t set eyes on each other until both came to Kentucky for the National Kidney Foundation’s 2006 U.S. Transplant Games. “I loved her already,” says Meyers, 69, of Springfield, Missouri. “Through her, Debbie, my firstborn and only daughter, lives on.”

Conley, who lost her own mother and other relatives to polycystic kidney disease, says she has never felt better. She proved it at the Transplant Games by winning a whopping four medals for everything from swimming to golfing. Throughout every competition, Meyers was rooting her on. “I just kept saying, ‘I’m so proud of you!’ And I was. That girl sure can swim!” Since the transplant, Conley has the strength to swim 20 laps and play 18 holes of golf on a regular basis. “I am so grateful,” she says. “Every Sunday, I pray for Linda and her family and light a candle for Debbie. What Linda did is awesome. I feel very lucky to know her and to honor Debbie by being the healthiest person I can.”

EMPOWERING CONSUMERS WITH KNOWLEDGE ABOUT WHO IS AT RISK AND WHEN TO GET KIDNEY FUNCTION TESTED WAS THE FOCUS OF THIS YEAR’S PUBLIC

PUBLIC EDUCATION

EDUCATION INITIATIVES. THROUGH FREE KIDNEY SCREENINGS, PUBLIC SERVICE CAMPAIGNS AND COMMUNITY OUTREACH, OUR LIFE-SAVING MESSAGE OF EARLY DETECTION REACHED MILLIONS.

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Photo: Erica Berger

Photo: Erica Berger

EARLY DETECTION SAVES LIVES The Foundation’s Kidney Early Evaluation Program (KEEP) is finding kidney disease at the earliest stage when prevention of kidney failure is still possible. This year, KEEP offered free screenings to 22,000 people in communities across the U.S. Although ninety percent of KEEP participants had visited their doctors in the 12 months prior to the screening, most were not aware they could be at risk for chronic kidney disease (CKD). In many cases, doctors were treating high blood pressure and diabetes alone, but not as risk factors for CKD, so the participants had not had their kidney function tested at regular checkups. After the screenings, 60% reported consulting with their doctors about the results and NKF’s treatment recommendations. KEEP is supported by Abbott, Amgen, Novartis Pharmaceuticals, Ortho Biotech Products, L.P., Siemens Medical Solutions Diagnostics, Lifescan, Inc, OceanSpray Cranberries, Inc. and Suplena®. This year, the NKF helped spark a national conversation on the power of early detection by joining forces with Foundation spokesperson George Lopez in a special episode of his popular ABC TV sitcom, “The George Lopez Show.” “The Kidney Stays in the Picture” episode was followed by a post-show informational announcement. As a result, the National Kidney Foundation received more than 3,500 hits to our Web site and more than 500 calls to our national hotline. NKF distributed hundreds of “Are You at Risk?” brochures and nearly 700 people downloaded the Spanish version of that publication from NKF’s Web site.

FIRST-EVER WORLD KIDNEY DAY

CA R O LY N P R I C E

In March, the Foundation took the lead on promotion for the first-ever World Kidney Day, a newly-established annual health observance designed to raise awareness about risk factors and early detection. Through print public service announcements in USA Today, national radio interviews, and news stories in local papers and TV broadcasts around the country, NKF encouraged Americans to take one positive action that day—to learn their family’s health history and get checked out if they learn they are at risk.

Photo: Rob Tannenbaum

“They see how good I look, how healthy I am. That’s so important to see a living, breathing example of a transplant recipient, particularly an African-American, like them.” “Advocate” is far too passive a word for Carolyn Price. The Jackson, Mississippi native is a force of nature who stormed (politely, of course!) Capitol Hill in April, along with other “People Like Us” patient advocates. Her mission was to educate lawmakers about the crucial need to allocate money for all aspects of organ donation, ranging from research to financial reimbursement for living donors. Price didn’t stop after successfully enlisting her congressman, Rep. Bennie Thompson, to join the Congressional Kidney Caucus. She also cornered a congressman from Louisiana to request funding for the Organ Donation and Recovery Act. “I can’t even vote for him and he knew it!” reports Price, 55.

The Foundation was also honored with the ringing of the NASDAQ Closing Bell on World Kidney Day, and our message, NKF logo and 30-second TV spot were given prominence on the NASDAQ screen in New York City’s Times Square throughout the day. The Closing Bell Ceremony was covered by CNBC and Bloomberg Television.

Photo: Marc S. Levine

It was a true home run for health when NKF teamed up with the New York Mets for a special Kidney Awareness Day at Shea Stadium, hosted by NY Mets outfielder Cliff Floyd during an August home game. Floyd, who knew about his dad’s history of kidney disease, made sure to get himself tested and took steps to keep his early kidney disease under control. He taped a TV spot comparing his all-out efforts to perform at the highest levels on the field, to that of his kidneys’ less than stellar performance. He encouraged others to check out their kidneys before it becomes too late. The spot was played repeatedly on the stadium’s Jumbotron during Kidney Awareness Day, and NKF provided informational brochures to thousands of fans seeking to learn more.

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KIDNEY DAY AT SHEA

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When she was just 23, Price’s kidneys began to fail. “To this day, no one knows why,” she says. Though stunned, Price paid close attention to her doctor’s orders, exercised and ate properly, and managed to forestall dialysis until she was 46. Three years later in 1999, she received a transplant at the University of Mississippi Medical Center. Since then, there isn’t much Price, a mother, grandmother and regional manager for BellSouth, won’t do on behalf of the National

Kidney Foundation. As an African-American—a population disproportionately affected by kidney disease—Price does extensive outreach work. She speaks at community meetings and health fairs, as well as from church pulpits. She also visits dialysis centers to encourage those who need transplants to move forward, even if they are afraid. “They see how good I look, how healthy I am. That’s so important to see a living, breathing example of a transplant recipient, particularly an African-American, like them,” she says. What’s more, the woman who prefers marathon shoe shopping to sports has even competed in the U.S. Transplant Games. “I bowl,” she says, laughing, “and I’m really lousy at it.” What Price excels at is feeling gratitude for being alive. “In the deepest moment of despair a family who lost their 13-year-old son donated his organs and gave me and others a chance at a normal life,” she says. “How could I not give back?”

FROM THE 74-YEAR-OLD FARMER IN BANCROFT, IDAHO, TO THE 18-YEAROLD HIGH SCHOOL STUDENT IN BATON ROUGE, LOUISIANA, THE NKF’S PATIENT SERVICES PROGRAMS REACHED OUT

PATIENT SERVICES

TO MILLIONS OF AMERICANS WITH CHRONIC KIDNEY DISEASE BY OFFERING EASY ACCESS TO VITAL HEALTH INFORMATION, ONGOING PERSONAL SUPPORT AND LIFE-SAVING PROGRAMS.

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Photo: Erica Berger

PATIENT SUPPORT AND EMPOWERMENT Chronic kidney disease (CKD) can often disrupt the flow of family life and derail personal dreams with lengthy, ongoing treatment and related medical issues that constantly arise. NKF Affiliates around the country are working to empower patients and families to achieve their life and career goals and enjoy socialization. Summer camp programs are offering ways for kids and adults with CKD to reclaim a normal life in the face of kidney disease. College scholarship programs are doing the same for people on dialysis who are seeking retraining. When emergency strikes and power is about to be shut off, medication is running out or the eviction notice is on the door, NKF Affiliates can be relied upon for financial assistance.

KATRINA AFTERMATH When Hurricane Katrina devastated the Gulf Coast region, local residents and fellow Americans set about trying to repair physical damage and destruction in order to return a sense of normalcy to daily life. Renovating homes proved easier than rebuilding traumatized psyches, especially among those whose personal and professional survival depended on receiving and providing life-saving dialysis treatments in the face of a natural disaster. NKF’s “People Like Us: Stepping Back into Life” initiative is addressing the trauma, despair and depression plaguing the Gulf Coast through a CD-ROM program that offers support and coping tools for patients. The program, to be delivered by professionals, will reach thousands of people on dialysis, as well as kidney care professionals in the New Orleans, Baton Rouge, and Lafayette areas. Every single dialysis social

M A RY W E N D T “I am so impressed by my patients... I often think they help me cope more than I help them.”

worker in the state will receive one as well.

DIALYSIS EDUCATION

Mary Wendt listened as the woman spoke haltingly of her feelings of sadness since Hurricane Katrina had devastated her hometown and upended her life. “I’ve got to stop talking about all this loss or I’ll cry,” the woman said quietly. Wendt, a dialysis social worker in New Orleans, comforted the normally stoic patient by saying, “This is the place to cry! Right here!” Though Wendt is kindly and soft-spoken, she also happens to be a veteran social worker who can cut through the thicket of bureaucracy like a chainsaw if it means securing financial aid and other services for her dialysis patients.

NKF Affiliates offered peer mentoring programs to help new patients adjust to life on dialysis by pairing them with seasoned patients who could share the benefit of their own personal experience and offer encouragement and support.

FAMILY FOCUS

Photos: Erica Berger

The kidney community’s quarterly newspaper, Family Focus, continued to address key issues that touch the lives of people on dialysis and their families. This year’s articles focused on Medicare Part D coverage for dialysis, quality of life issues and disaster preparedness. The newspaper was mailed to every dialysis unit in the country, as well as to 42,000 home subscribers.

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Dialysis is a life-saving treatment for hundreds of thousands of people with kidney failure, yet the process itself can be complex and misunderstood. NKF’s Patient and Family Council has long been dedicated to tackling issues affecting individuals with kidney disease and their families. This year, it developed nationwide education initiatives to help people facing kidney failure understand the different options available to them, as well as the safest and most effective ways to receive treatment.

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Katrina has left behind the sort of emotional damage that requires extraordinary training and care. That’s why Wendt, former president of the Foundation’s local Council of Nephrology Social Workers, has helped organize the National Kidney Foundation’s “People Like Us: Stepping Back into Life” program, which was created to help those on dialysis cope with lingering post-Katrina trauma. Social workers throughout Louisiana have received kits that

include a two-part audio CD, along with a facilitator’s guide they can use in a classroom setting. Additionally, patients undergoing dialysis can listen individually to a CD about how to get through depression and hear people like themselves tell their personal stories. “Many have lost their homes, family, friends, churches, even transportation to and from the dialysis clinic,” says Wendt, a New Orleans native. ”They still have to deal with a chronic illness that requires a healthy diet, medications and dialysis. It’s staggering. Most don’t identify what they’re feeling as depression. They say they’re ‘tired’ or ‘stressed.’ We are so grateful for anything that helps us help them to cope.” Wendt, whose home received only minor damage, says she is profoundly moved by the patients, whose fortitude sets an example for the doctors, social workers and staff. “I am so impressed by my patients,” she says. “They are poor, they’ve been shaken to their core, and with all the stress and the loss of their support systems, they aren’t whiners. I often think they help me cope more than I help them.”

EVERY 11 MINUTES A NEW NAME IS ADDED TO THE ORGAN TRANSPLANT WAITING LIST AND

ORGAN AND TISSUE DONATION

EVERY DAY 18 PEOPLE DIE WHILE WAITING. THROUGH AWARENESS ACTIVITIES AND SUPPORT, THE NKF’S ORGAN DONATION INITIATIVES AIM TO CHANGE THOSE NUMBERS.

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Photo: Erica Berger

THE NATIONAL KIDNEY FOUNDATION U.S. TRANSPLANT GAMES

Photo: Eric Miller

The life-saving power of organ donation was portrayed in vivid color this summer as more than 1,200 transplant recipient athletes from around the country played on their own field of dreams at the Olympic-style 2006 U.S. Transplant Games in Louisville, Kentucky. Together with their families and organ donors, over 7,000 Games participants showcased the success of transplantation and encouraged organ donation, as they competed for medals in 12 different sports. At the Donor Recognition Ceremony and the Living Donor Recognition Event, they honored those who gave the gift of life. Through the participation of high-profile national spokespeople, the event drew widespread media attention to the organ and tissue donor cause. The inspirational personal stories of Photo: Eric Miller

those American heroes whose lives were touched by organ transplantation, either through giving or receiving the gift of life, were highlighted through coverage by the Associated Press; CNN; National Public Radio; CBS TV; USA Today; Good Housekeeping, Parents, Runner’s World, Prevention magazines and numerous others.

DONOR AWARENESS CAMPAIGNS The organ donor message was broadcast throughout the year with the NKF’s Donate Life Month Campaign in April and the Holiday Gift of Life initiative at year-end. Both promotions pointed out the weightiness of the number 91,000, especially as it measured lives

E M I LY B I O N D I

on the waiting list for organs. The holiday campaign urged consumers to take a break from traditional gift-giving with a new tradition that wouldn’t break the bank: signing up Photo: Eric Miller

“My doctor calls me when young patients need a transplant, and I go and talk to them.”

for organ donation. This gift is in the true spirit of personalized, holiday giving that doesn’t cost a cent. The Foundation reminded Americans that one such gift could ultimately make many people happy, since one organ and tissue donor has the potential to save 50 lives.

IMPROVING TRANSPLANT CARE Two NKF initiatives focused on improving the care and health of transplant recipients over the long term so that they can preserve the gifts bestowed upon them by organ donors. The first was a global conference that laid the groundwork for a new clinical practice guideline on transplantation, funded by the NKF Board of Directors, and the second was a study

The conference, initiated by Kidney Disease: Improving Global Outcomes (KDIGO), an international organization managed by the NKF, focused on reducing the need for second transplants through development and implementation of guidelines. These guidelines will help doctors around the world manage complications associated with kidney transplantation and help recipients live long and healthy lives. This year, the NKF also launched a long-term initiative addressing levels of awareness among

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investigating the awareness of cancer risk among transplant recipients.

transplant recipients about their increased risk of cancer, and providing education to health care Photo: Emily Newell

professionals and recipients about the best ways to prevent and treat post-transplant cancer.

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As Emily Biondi racked up medals at the recent U.S. Transplant Games, her father Norman watched with pride and bemusement. Emily, 23, won silver medals in the 100-meter backstroke, the 5K and the 200-meter run, and a gold in the long jump. Her father, a financial planner in Ellicott City, MD, shook his head. “This was a girl who refused to go out for high school sports because of that sweating thing,” he reports wryly.

Emily is now majoring in health administration and public policy at the University of Maryland, Baltimore County, and plans to work in the area of transplantation or stem-cell research. On weekends, Emily performs at a dinner theater. On Friday nights and Sundays she is Violet Bick in “It’s a Wonderful Life,” and on Saturdays she is Glinda in “The Wizard of Oz.” Last season, she played the lead role in “The Little Mermaid.”

That’s the thing about Emily—she endures, overcomes and soars, all seemingly without breaking a sweat. Near the end of her sophomore year at Florida Southern College, Emily, a theater and dance major, began to feel so depleted that she could barely get out of bed. Her mother brought her home and eventually doctors discovered the otherworldly fatigue was kidney failure. Emily underwent a blood transfusion and began dialysis. At just 19, she needed a kidney transplant. Her father came to the rescue with “Lefty,” what Emily calls his donated kidney. Lefty has not only saved Emily’s life, but has transformed it.

Emily has taken on a new real-life role as well. “I’m sort of a preacher and poster child for transplantation,” she says. “My doctor calls me when young patients need a transplant, and I go and talk to them. I’m also very involved with Team Maryland, the state Transplant Games Team. It’s a great group.” Better than the medals, Emily says, was the honor of having sung at the closing ceremonies of the Transplant Games: “It was a fun place to shine and to show that people with organ transplants don’t have to give up. They can live great lives!”

DELIVERING CUTTING EDGE CLINICAL PRACTICE GUIDELINES

PROFESSIONAL EDUCATION

AND COMPANION TOOLS SO THAT KIDNEY PATIENTS CAN BENEFIT FROM THE LATEST SCIENCE WAS A MAJOR FOCUS THIS YEAR.

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Photo: Erica Berger

NKF’S KIDNEY DISEASE OUTCOMES QUALITY INITIATIVE (KDOQI) KDOQI, now in its 10th year of providing evidence-based recommendations to improve kidney patient care, published new clinical practice guidelines on anemia in chronic kidney disease (CKD) last spring. These are the first guidelines to address diagnosis and management of anemia at all stages of kidney disease. They advocate that all CKD patients be evaluated for anemia—one of the complications of CKD that is most responsive to treatment—and that hemoglobin levels be maintained above 11 grams per deciliter. In addition, the KDOQI clinical practice guidelines for hemodialysis adequacy, peritoneal dialysis adequacy and vascular access were updated and published in July 2006. This represented the second update of these landmark guidelines, which have measurably improved outcomes as increasing numbers of patients have reached target levels established by KDOQI. According to recent reports from the United States Renal Data System, survival rates for dialysis patients have improved since the KDOQI guidelines were originally released in 1997. The latest data shows a 6.5% increase in five-year survival rates for hemodialysis patients and a 14% increase in five-year survival rates for peritoneal dialysis patients. Based upon these KDOQI publications and through the collaborative dedication of NKF volunteers, NKF’s Kidney Learning System (KLS)™ developed innovative tools and informative materials to help physicians and health care professionals

L E S L I E S P RY

implement the recommendations. These include the Dialysis Care Package, a specially designed boxed-set of materials based on the KDOQI 2006 Updates for

"It’s all about public education, one more way to give people knowledge. Give them information that they pay attention to and learn from, and you can save lives. That’s what I want."

Hemodialysis Adequacy, Peritoneal Dialysis Adequacy and Vascular Access; Anemia in CKD; and Cardiovascular Disease in Dialysis Patients. This comprehensive educational package consists of manuals, handbooks, patient brochures in both English and Spanish, a CD-ROM and a wall chart.

Leslie Spry is every kidney patient’s dream doctor. A man of science, except for a boundless faith he places in his beloved Cornhuskers, the former farmboy from Broken Bow, Nebraska, is a top notch nephrologist who also happens to be a great guy.

KLS developed additional new materials that will help professionals provide patient education, and offered a wide range of innovative continuing medical education and continuing education (CME/CE) opportunities on a variety of topics including diabetes, cardiovascular disease, anemia, mineral and bone disorders and infectious diseases. CME/CE is developed using multi-media, which expanded this year to include downloadable mobile technology accessible via health care

KLS programs were also featured as live symposia, clinical meetings, on-line Webcasts, CD-ROMs and monographs. CME/CE activities are accredited for all disciplines of the health care community, ranging from pharmacists and nurses to dietitians and social workers to dialysis technicians and nephrologists. In addition, KLS addressed the needs of its target audiences by increasing CME/CE opportunities for doctors of osteopathy, family practice physicians, advance practice Photos: Erica Berger

nurses and physician assistants.

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providers’ personal digital assistants, or PDAs.

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“I admire my patients. They are very brave folks,” says Spry, 55. He is the medical director of the Dialysis Center of Lincoln, Nebraska, where he treats patients and participates in research and innovative projects to help improve dialysis care. “They live with a chronic disease. That’s no small thing. My role is to help them cope, to offer them information and care that will make their lives easier.” For Dr. Spry, a member of the National Kidney Foundation since 1981 and a frequent media spokesman for the organization, that means educating all Americans about kidney disease. In the early ’80s, Spry developed a patient education effort in St. Louis. It was the seed from which NKF’s

“People Like Us” program grew. He helps the NKF develop and review brochures and publications for professionals, patients and the general public. In other words, he wrings out the medical jargon and rings in patient-friendly prose. “I don’t talk about “glomerulus” when I mean “kidney filter,” he says, laughing. “I’m a translator.” And, at heart, a teacher. He is on the steering committee for an exciting NKF project that will educate patients about dialysis and transplantation through comic strip characters based on real life patients and their stories. “People are frustrated and frightened by dialysis, transplants, the bureaucratic medical maze,” he says. “Facts are important, but if you give people facts in the form of stories they’ll mean something. They will remember them. It’s all about public education, one more way to give people knowledge. Give them information that they pay attention to and learn from, and you can save lives. That’s what I want.”

EMPOWERING OUR CONSTITUENTS TO SPEAK UP WHEN IT COMES TO THEIR OWN HEALTH CARE AND ENSURING THAT THEIR VOICES ARE HEARD BY THE U.S. CONGRESS IS THE

ADVOCACY

FOCUS OF NKF’S ADVOCACY EFFORTS AND THE “PEOPLE LIKE US” INITIATIVE. AS A RESULT, LAWMAKERS PAID INCREASED ATTENTION TO KIDNEY DISEASE AND ORGAN DONATION ISSUES THIS YEAR.

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Photo: Erica Berger

NKF’S “PEOPLE LIKE US” Through the “People Like Us” program, patient advocates built support for the Foundation’s legislative priorities by contacting and visiting their U.S. congressional delegations to request increases in vital research funding. They also advocated for public policies that advance organ donation and kidney disease education. NKF helped make this happen by providing ongoing advocacy training for patients on issues such as preparing for congressional visits, the roles of Photo: Lauren Burke

key congressional committees and NKF public policy priorities. In April, the Foundation joined forces with 12 other transplant-related organizations to urge Congress to fund organ donation programs as part of the Organ Donation Recovery and Improvement Act of 2004. The daylong “fly in” included visits to 50 House and Senate offices, where provisions including financial assistance to living organ donors, and extension of Medicare coverage for vital immunosuppressive drugs for kidney transplant recipients, were discussed. Fewer than half of new kidney failure patients receive the information they need to fully understand their diagnosis and the various treatment options available to them before beginning dialysis treatment. In a valiant attempt to change those numbers, “People Like Us” advocates from across the country flew to Washington, D.C., in June, urging lawmakers to support the Kidney Care Quality

J I M M C D E R M OT T

and Improvement Act. This comprehensive legislation would provide Medicare coverage of pre-dialysis education, and ensure that Medicare’s payment for dialy-

“Kidney patients look to political leaders and we must not let them down.”

sis would keep pace with inflation. The advocates participated in nearly 30 congressional meetings. Their hard work paid off when Congress responded in late December by passing a provision that would increase the rate of Medicare payment for dialysis treatment.

When it comes to power and passion, kidney patients could not dream up a better advocate than U.S. Representative Jim McDermott (D-WA), now serving his 10th term in Congress. His philosophy of public service is, “We can transform common dreams into the common good.”

Persistence paid off once again this year when the Centers for Disease Control and Prevention (CDC) awarded a grant to NKF for the implementation of a chronic kidney disease (CKD) screening program on both the federal and state levels. The program, which was established in 2006, targets Americans at high risk of CKD in

Photo: Lauren Burke

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order to detect it early on and improve patient outcomes.

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The first member of his family to graduate from college, McDermott, a Seattle resident, has served his country in a multitude of ways. He’s a physician with a specialization in psychiatry, and he has served in the U.S. military. In 1987, after 15 years in the Washington state legislature, he left politics and headed to Zaire, where he provided psychiatric services to Foreign Service, USAID and Peace Corps workers. Congressman McDermott is particularly proud of the Northwest Kidney Center in Seattle, created by his friend, the kidney dialysis pioneer and inventor of the Scribner shunt, Dr. Belding Scribner. Together, Congressman McDermott and the Center have shown the advantages of home hemodialysis and more frequent dialysis therapy.

Congressman McDermott has introduced legislation that would promote this as a member of the Ways and Means Committee. “Kidney patients look to political leaders and we must not let them down.” In 2002, Congressman McDermott established the Congressional Kidney Caucus with Congressman Mark Kirk (R-IL). It is his way of educating his colleagues about the disease and rallying lawmakers to allocate funding for research, prevention and emotional and financial help for those on dialysis or awaiting transplants. In the future, he hopes the Caucus will reach out to new Members of Congress, to educate them about the numerous issues kidney patients face, and the responsibility of political leaders to take positive action on their behalf. “We each have our heroes. Gandhi is one of mine. Gandhi said, ‘Be the change you want to see in the world.’ Those are words to live by and a philosophy to guide us in making laws that affect the lives of the American people.”

WHAT CAUSES KIDNEY DISEASE? HOW CAN WE PREVENT ITS PROGRESSION TO KIDNEY FAILURE? AND, WHAT CAN WE DO TO IMPROVE QUALITY OF LIFE FOR THOSE WITH KIDNEY DISEASE TODAY? NKF’S RESEARCH PROGRAM AWARDS NEARLY $3 MILLION

RESEARCH

ANNUALLY TO THE BRIGHTEST MINDS IN SCIENCE SO THAT EVERY DAY WILL BRING US CLOSER TO FINDING THE ANSWERS TO THOSE QUESTIONS. MORE THAN 60 AWARDS ARE GRANTED THROUGH NKF’S RESEARCH FELLOWSHIP, YOUNG INVESTIGATOR AND CLINICAL SCIENTIST PROGRAMS. 28 29

Photo: Erica Berger

CARDIOVASCULAR DISEASE Cardiovascular disease (CVD) is much more common among people with kidney disease than it is in the general population. In fact, CVD is the leading cause of death among kidney patients. The causes of CVD in kidney patients are still being investigated. Denis Glenn, MD, PhD, is an NKF Research Fellow at the University of California at San Francisco. He is exploring the possibility that decreased levels of active vitamin D seen in many kidney patients may be an important factor in their increased risk for CVD. Earlier studies suggested that vitamin D may act directly on heart tissue and may have a protective role in heart failure. Dr. Glenn’s findings may lead to new treatment strategies for CVD in kidney disease.

HIGH BLOOD PRESSURE High blood pressure is a leading cause of both heart disease and kidney disease. It is the primary diagnosis for a fourth of the patients whose kidneys fail each year in the U.S. However, the causes of high blood pressure are largely unknown. Julie Goodwin, MD, an NKF Research Fellow at Yale University Medical Center, plans to investigate the role of certain drugs known as steroids in causing or exacerbating elevated blood pressure. Dr. Goodwin’s study will involve blocking steroid receptor sites in specific tissues such as the kidneys and blood vessels. She hopes to determine where steroids have the greatest effect on blood pres-

R O B Y N C U NA R D

sure and what treatment strategies could be used to prevent this problem.

“The NKF has given me the most important gift: protected time. Research is impossible without it.”

VASCULAR ACCESS When kidney disease progresses to kidney failure, treatments such as transplantation or dialysis are needed to maintain life. Hemodialysis is the most common form of kidney replacement therapy. Vascular access, or entrance to the blood-

Robyn Cunard had made up her mind to become an engineer, but when life whispered a different plan on a roadside in Upstate New York, she paid attention. At age 16 she became the youngest member of a volunteer ambulance corps in tiny Goshen, New York. “We were called to a tanker accident and the guy was pinned inside,” she recalls. “My job was to hold his hand while the fire guys came in to extract him. It felt right holding his hand, comforting him.” The aspiring engineer was no more. Her future was now in medicine.

stream, is needed to allow the patient’s blood to travel through a special filter called an artificial kidney for removal of impurities from the blood. Vascular access is an important factor in how well patients do on hemodialysis. This year, two NKF Research Fellows at the University of Alabama at Birmingham, Jimmy Lee, MD, and Ivan Maya, MD, are exploring ways to improve the use of different types of vascular access. Dr. Lee’s study focuses on arteriovenous fistulas (AVFs), which are the preferred type of access for most hemodialysis patients. Dr. Lee plans to perform ultrasound exams of AVFs at one month after placement to determine whether this will make it possible to increase the number of AVFs that mature and are used successfully. Dr. Maya’s study focuses on grafts, the second best type of access. His observations are aimed at finding out whether treatment of clotted grafts is more successful when angioplasty, a procedure to open blocked vessels, is combined with placement of a wire mesh tube, or stent, at the affected site.

profile

Photos: Erica Berger

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These days, the 39-year-old nephrologist is a gifted researcher and recipient of many prestigious awards, including two National Kidney Foundation grants. A staff physician at the Veteran’s Administration Health Care System San Diego and an assistant professor of medicine at the University of California, San Diego, she devotes her time to researching PPAR ligands. Cunard believes that drugs already taken by many people to treat diabetes and

high lipids/cholesterol may also help those with kidney disease. She has discovered that PPAR ligands are anti-inflammatory agents, which help fight infections in the body. In her experiments, these ligands have slowed the progression of inflammatory kidney disease in mice. “I love this research,” she says. “It’s very exciting because it’s practical and clinically relevant.” Cunard, who lives with her journalist husband and their two babies, says she could not have done this research without the NKF. The first grant she received, in 2002, paid for a lab technician. “She is still with me, I’m proud to say,” Cunard reports, then adds wryly, “though I’m very hands-on.” The NKF’s most recent grant, the Clinical Scientist Award, pays part of Cunard’s salary, enabling her to concentrate on science. “The NKF has given me the most important gift: protected time,” she says, gratefully. “Research is impossible without it.”

THIS YEAR, OUR FUNDRAISING ACTIVTIES WERE ALL ABOUT PARTICIPATION. WHETHER THEY WERE EMPLOYEES, FAMILY MEMBERS OF KIDNEY PATIENTS OR GOLFERS, NKF’S DONORS EXPERIENCED

FUNDRAISING

FIRSTHAND THE LIFE-SAVING IMPORTANCE OF THE FOUNDATION’S FAR-REACHING PROGRAMS. NEW ALLIANCES WERE FORGED, GRASSROOTS FUNDRAISING GREW STRONGER AND CORPORATE PARTNERSHIPS WERE STRENGTHENED AND EXPANDED.

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Photo: Erica Berger

CB RICHARD ELLIS CARES In 2006, NKF was chosen by CB Richard Ellis (CBRE), a global market leader in real estate, as a partner for CBRE Cares, their inaugural national corporate philanthropy program. This Fortune 500 company with over 350 offices nationwide encouraged its 10,000 employees to contribute financially and to become personally involved with its partner organizations. NKF and its Affiliates participated in over 50 CBRE Cares campaign kick-off events held around the country. The new corporate partnership is an exciting opportunity for the Foundation to join forces with a dynamic global organization, and to gain more volunteers, more awareness and more funds to support NKF’s life-saving programs.

KIDNEY WALKS With 72 events held this year in cities around the country, the Kidney Walk has grown tremendously in popularity and success. New initiatives in corporate sponsorship recruitment and building of the Walk team structure attracted 20,000 walkers and generated nearly $3 million.

GOLF CLASSIC The National Kidney Foundation Golf Program transitioned to an independent, newly branded platform in 2006. Thousands of golfers participated in 30 NKF Golf Classic signature tournaments that were conducted throughout the country. Along with our continued partnership with Pebble Beach Resorts, NKF’s Golf Classic program secured new national sponsorships with PING and Tourneau, and a media partnership with Cingular Wireless.

R OY M A L K I N “It’s the NKF’s mission, its proactive prevention programs and the fact that each day the NKF provides ‘real time’ assistance to those who suffer from kidney disease.” When Roy Malkin was asked to be the Honorary Chairman of the 2006 Kidney Walk in Minneapolis, he agreed, but with one caveat: “The local NKF Division had established a fundraising goal of $75,000,” recalls the 61-year-old president and CEO of Minnesota-based Minntech Corporation. “I said that was totally unacceptable. We’ve got to raise in excess of a quarter of a million dollars!”

HEALTHY KIDNEY 10K

KIDNEY CARS PROGRAM

Photo: Rich Mullane

Once again, used cars breathed new life into NKF’s myriad of projects through the Kidney Cars Program. This nationwide vehicle donation program continued to see improvements in net returns as a result of new online marketing tactics that have led to a dramatic increase in Internet-based donations. Currently, more than 60% of donations are made on-line, a practice that reduces costs and increases profit. This year, more than 40,000 cars became Kidney Cars, generating nearly $12 million to support our life-saving programs.

profile

More than 6,000 runners teamed up to learn about kidney health, while raising funds for the NKF as part of the second annual Healthy Kidney 10 K Run. The race, held in Central Park in New York City, was sponsored by the Embassy of the United Arab Emirates (UAE) and raised over $200,000. The Healthy Kidney 10K pays tribute to the former UAE president, Sheikh Zayed Bin Sultan Al-Nahyan, who benefited from American expertise, knowledge and research when he received a kidney transplant in 2000.

Photo: Acey Harper

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And Malkin meant it. This first-ever Kidney Walk brought in $275,000. He credits his 375 employees for the core of that success. “We mobilized our team and the rest is history,” he says proudly. “Minntech Magic,” as the walk team was dubbed, began its efforts five months in advance. Employees were able to buy extra vacation days for a Kidney Walk donation of $50 per day for hourly employees, and up to $175 for senior executives. Every subsequent month leading up to the event brought a different team-building, fundraising activity such as the chance to dunk the executives, Malkin included, in a giant water tank. Malkin, who runs on equal parts enthusiasm and pragmatism, was thrilled with Minntech Magic’s success, which raised over $145,000 for the NKF. But Malkin insisted on giving the NKF far more than just money. His team members created a Corporate Walk Team prototype program

complete with CD. “It’s a mission for us,” he says. “We want other companies throughout the country to say, ‘We can do this, too. We can create the same level of enthusiasm and achieve a very positive outcome.’” Malkin added, “We’ve proven that you don’t have to be a huge company to be extremely effective!” Malkin presented his prototype program at the NKF’s Kidney Walk Academy, an annual training program for those who organize local Kidney Walks. “I was pleased with the response and I volunteered to go anywhere they needed me to get the word out,” he said. A former Vietnam era combat and test pilot whose hobbies now include building and flying seaplanes, Malkin also has personal reasons for supporting the NKF. His wife received a kidney from one of their daughters, and their other daughter was born with only one kidney. “But that by no means is the driving factor for my involvement with the National Kidney Foundation,” says Malkin. “It’s the NKF’s mission, its proactive prevention programs and the fact that each day the NKF provides ‘real time’ assistance to those who suffer from kidney disease. Those activities and many more make all of us very pleased to be a small part of such a valuable endeavor.”

OUR SUPPORTERS

CORPORATE PARTNERS

The Ada DeBold Society

Our corporate and organizational partners are critical to our success in developing and implementing world-class educational intiatives, programs and events. This year, contributions from national corporate partners supported NKF in the development of clinical practice guidelines for physicians, as well as community-based programs for those at risk for kidney disease and those already suffering from kidney disease.

PLATINUM

BRONZE

SUPPORTER

Abbott

Siemens Medical Solutions Diagnostics

Baxter Healthcare

Amgen Novartis Pharmaceuticals Corporation

Genentech, Inc.

C.B. Richard Ellis

Lifescan, Inc.

Jewish Hospital & St. Mary’s Healthcare

Ortho Biotech Products, L.P.

Luipold Pharmaceuticals, Inc.

Mayo Clinic

Roche Pharmaceuticals

Musculoskeletal Transplant Foundation

Phi Sigma Sigma Foundation

Wyeth Pharmaceuticals

Nabi Pharmaceuticals OceanSpray Cranberries, Inc.

GOLD Genzyme

Pfizer Inc.

Astellas Pharma US, Inc. Embassy of the United Arab Emirates

Takeda Pharmaceuticals Tourneau

FRIEND CONTRIBUTOR Atlas Telecom

SILVER

Satellite Healthcare, Inc.

Sanofi-Aventis

GlaxoSmithKline Shire

The Ada DeBold Major Giving Society represents individuals and organizations who have made generous contributions to further the work of the National Kidney Foundation in the 55-year-old tradition of Mrs. Ada U. DeBold, one of the founder’s of the National Kidney Foundation.

Bristol-Myers Squibb Cingular Wireless Fresenius Medical Care International Golden Group

Merck & Co., Inc.

Keryx Biopharmaceuticals, Inc.

Ross Products Division Abbott Laboratories

KOS Pharmaceuticals

Watson Pharma, Inc.

Northwest Airlines

AlGeco Brown-Forman Beverages Code Contracting Company Jumeirah LifeTrac Transplant Network Lockheed Martin Omeir Bin Youssef & Sons The Wendy Marx Foundation for Organ Donor Awareness

Mediflex Pebble Beach Company PING United Resource Networks

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Abbott Laboratories Renal Care Alabama Organ Center Stuart & Louis Abramson University of Alabama Charles E. Alfano Susan Alfano Brad Allen Joe Andres Margaret R. Anson E. Arditti Charitable Foundation David Ashbach, MD Jon & Helaine Ayers Greg Baron Stephen T. Bartlett, MD Rod & Tina Bascom Maureen Basney Susan Baumgardner Andrew N. Baur Liz Beck Richard & Lisette Bernard Boren Family Foundation Louis Borick D. Stuart Bowers Christine Brauss Susan Patla Brereton John Brockington Foundation John Broderick David G. Bucher James Burke, MD Bob & Wauneta Burkley Phillip & Karen Burrell Sam R. Buxton, III Drs. Jeanne & Chuck Cangro John & Sonya Cattelan Estate of Samuel A. Clauss James Clayton & Clayton Family Foundation Dr. Arthur & Susan Cohen Sue Ann Collins Brian & Carol Condon Anna & Charles Conigliaro Foundation

Curtis & Jewel Cooke Peter & Alkene Cooley W. Michael Craig Tim Craig Dan & Jeanne Cuda Brayden Curley Paul S. & LaVerne D. Curley Glenn M. Cusick Brad & Rosemary Danielson Ronald DaVella Denise & John D’Avella John I. Denny Shirish Desai Bob & Alie DiCarlo Dickson Foundation, Inc Brian Dilsheimer Paul & Kathleen Dioli David R. Doebler Mary-Susan & Brian Donhauser Roy Dorsey Richard Drake, MD Marcy Edmiston Julia Esdale Curt & Cindi Fankhauser Kathy & Ken Felton Margie L. Fort Albert A. Fox Dr. & Mrs. K. Trevor From William Lee Frost In Memorium Stella Green Gaignard James W. Gallaher Christopher T. & Terri P. Gallu SFC Charitable Foundation, Inc. Gelfand, Rennert, & Feldman Terrence & Julie George Steve & Mindy Geppi Thomas & Debra Gillespie Kenneth Glen Family Foundation Goodman Family Foundation Myra Goodman Smith

Rebecca Grahlkey Mr. & Mrs. Kenneth Gray Anne W. Griffin Nancy J. Gritter, MD Gerald Groggel, MD Milton & Alice Gross Peter & Alkene Halstead Kevin & Patricia Hannifan Kimberly & Eric Hathaway Glen Hayashida Daniel H. Hayes, MD Mr. & Mrs. Jonathan Hazman Al Hemond Trust Mary Kay Hensley Anne Hetrick Richard L. & Donna F. Hill Kevin N. Hill HK Management Trevor W. & Tracy L. Hoffman Charlotte Johnson Hollfelder Trust Paul Holloway Leonard Hopkins, Jr., Esq. Dr. & Mrs. Fred E. Husserl John Imbriale Dr. Donald Indadomi Paul & Beth Jensen Hazel Johnson Estate Harriet Jones Mr. & Mrs. Richard Jones Siegfred Kagawa Dr. Elaine Kamil Denice K. Keliikoa Leo & Sharon Kilcullin George W. King Thomas M. Kinkead, MD Dr. Edward & Joanne Kraus Herb Kritz Rebecca LeClair John T. Leonard Wanda C. Lessner

THE HERITAGE CLUB The Heritage Club, boasting more than 300 members, recognizes the generosity of donors who have designated NKF as beneficiary of planned gifts. Some have remembered the Foundation in their wills through bequests, some have named NKF partial beneficiary of life insurance policies and some have created charitable gift annuities or charitable remainder trusts.

OUR SUPPORTERS (continuation) Jay B. Levy, MD Bill & Meloney Liebler Walter and Vanita Luckett Eric Malm F. Stafford H. Manion Louis M. & Nancy A. Markwith Kevin J. Martin, MD Kevin Martin Fred Martin Stephen L. Mason Mike Masuda Ralph & Sandra Matteucci David D. Mayers John & Jill McAdams Francis McCusker, MD Charles McCutchen Kathleen McDermott Mrs. W. Randall McDonnell Helen & Bob McGraw Dr. & Mrs. William L. McGuffin Randall McGuire Tina & John McLaughlin Barbara J. McQuitty Carolyn McVitty Brian Menkhausen Paul A. Mennes, MD Estate of Anne J. Miller Jan Miller & Craig Lending Brent W. Miller, MD Rick Mishler, MD Hayse & Magdalene M. Mitchell Sharon Moe, MD Aubrey R. Morrison Estate of Clarence Moul Eleanor W. Myers Mr. & Mrs. Gordon Nahas Timothy R. & Marilyn M. Neal Walter R. and Beverly J. Neal New Orleans Nephrology Associates John & Nancy Newman Dr. Roland & Vivian Ng

Jerry, Rachel & Ethan Nichols Ed Nukala Payson Oberg, MD Deborah & Michael O’Connor Daniel B. Ornt, MD Robert Otto Anthony & Janice Parrotta Larry & Kathy Pearson Michael J. Pekos Thomas Peters The Petrides Family Jerry L. & Gina Pigsley C. Polack, MD Donovan Polack, MD Lou & Jean Pollock The Rachuba Family Foundation Mr. & Mrs. John Randall Laura I. Raukin, MD Estate of Eleanor Kreis Reed Francis Rieger Rudy Rodriguez, MD David Roer, MD & Mary Lizabeth Aquavia, MD Sally Rosenbaum Les Rosenthal Ralph L. Rousseau Mr. & Mrs. D. Mathias Roussy, Jr. Jerry G. Runion Charles E. Schleifer, MD Ruth Swett Schofield Scott & Heidi Schuster Mr. & Mrs. David D. Seifert Jame & Barbara Selzer Shaney Construction Company William Shepard Laura & John Shmerler Rosalyn Siegel Andrew Silverman Eduardo Slatopolsky, MD Dr. James & Mrs. Mary Ann Sloand Larry & Christine Snyder

Dr. Harvey & Miriam Solomon Patricia S. Spaulding Sally R. Stafford The Willie Stargell Foundation Gerald Stephanz, MD Stone Family Fund Stubblefield Foundation, Inc. Mr. & Mrs. Henry J. Suelau Stephen Sundheim Tim Taber, MD Ingrid Taylor, MD Patricia Thomas L. Scott & Marye Otto Thomlison Nancy Tringali Ernest & Rebecca Turner Luis G. & Audrea Uribe Johnny Walker Steven L. Walker Mr. & Mrs. Arthur R. Walker Dr. Bradley A. & Barbara Warady Milton Warshaw James Wasserman, MD Ronnie & Edna Weaver Mr. & Mrs. Frank W. Webber Dr. & Mrs. Phillip P. Weiner Dr. & Mrs. Matthew R. Weir Corbin & Kathy White James F. & Cecily Whiting Wichita Nephrology Group, PA Mike Williams Mr. & Mrs. Michael Duddley Williams, Sr. James Wilson & Associates Wolff Shoe Co. Foundation Paul Wurzer Roland & Dona Young Melvin Yudis, MD Brian & Beth Zorn Anonymous

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Bobby R. Abbot Gretchen A. Ackerson, CLU J. Douglas Adair Edward J. Amos Ray D. Amstutz Arlene Anderson Robert N. Baker Marion P. Baker Dianne P. Barth Helen L. Bartlett Joan M. Bayer Kenneth R. Beesley Susan K. Benner Steve & Sally Bieritz Brenda Borcherdt Ronald W. Borcherdt Jacques J. Bourgoignie, MD Mr. & Mrs. Norm Bowers D. Stuart Bowers Ken Bowman Camille D. Breen James K. Broughton Darrell M. Brown Charlene Brown Wendy W. Brown, MD Mr. & Mrs. Scott Buckley Connie Burnett Libby D. Buss Thomas Butler Mr. & Mrs. James A. Byrnes Molly Lillis Cahill M. David Campbell Kevin P. Carbin, Jr. Dan Carney Mary Carpenter Donna K. Carpenter Joseph C. Cerney, MD Mr. & Mrs. Vickers Chambless Sharon Chinnery E. C. ‘Sparky’ Clark Samuel A. Clauss Jane Claussen Louise Coates

Mr. & Mrs. Roger E. Coene Brenda Colby Allan J. Collins, MD Lori Collins Susan B. Conley, MD Norm S. Coplon, MD Scott Eugene Cote Cristin T. Cotton Missy Crawford Barbara Cross Mr. & Mrs. Timothy Crosson Dan & Jeanne Cuda Paul S. Curley Hisham Dado, MD Rosemary Danielson Gary W. Davis Robert Delonis Sandra DeTar, RD Ewart E. Dilks Randall Mark Divelbiss Mary Ellen Dix Mr. & Mrs. Bruce S. Dix Charles A. Drace, Sr. Marie Drysdale Max Dubrinsky Francis Dumler John L. Dunlap, MD Carla Duryee Brenda Dyson Drs. Gilbert & Rona Eisner Roy & Mary Ann Ekrom Mary Jean Emory Preston A. Englert, Jr. Karen Englesman Mr. & Mrs. John Faires Diane S. Farber Frank J. Fay Marcey Feigenbaum Mr. & Mrs. Milton Feinson Eben Feinstein, MD John Feliciano Thomas B. Ferguson Maurice Ferriter

Jay S. Finch John E. Firmin James L. Fortner JoAnne Fournier Irene Fox Diane French, RN, MPA Matthew C. Friederichs Daniel Fulcher Suzanne Gagne Terri P. Gallu Christopher T. Gallu Nicholas G. Gardner Warren E. Garling William Haskell Gates, III Gandolfo Chianchiano Jon W. Gilchrist Thomas & Debra Gillespie Mida Girogosian Leonard Gottleib Gary Green Stacy & Craig Groff Mr. & Mrs. Steven Grove Donna Gwin Herbert Hawthorne Terry P. Headley Mr. & Mrs. Don Heck Frederick A. Herbert Amy Jean Hicks Randy & Leslie High Elizabeth W. Hildenstein Richard L. Hill John Hoag Roswell & Elizabeth Hoffman Trust Barbara Hofstein Patricia A. Hormann Kathi Huenink Karen M. Ilstrup Mark T. & Cynthia A. Jacobson John Jamian Susan M. Jaskula Rafael A. Javier, MD Paul & Beth Jensen Charles Jones

THE HERITAGE CLUB (continuation) Neone Fitches Jones Kristi M. Jongeling Sally Joy Gary & Zeeva Kardos Naomi Kawakami Kirsten F. Kelly Mr. & Mrs. David Kelly Eleanor F. Kent Mr. & Mrs. Mel King George W. King Karren King, LCSW, MSW, ACSW Helen W. Kinnaird Estate Gerald A. Klisz Susan Knapp Joel D. Kopple, MD Robert D. Kranz Gerald D. Kumin, MD, PC David R. Lake Chris Leonard Gus Levy, CPA Lawrence Ley Mildred Lichtig Mary Lin Donald E. Linnartz Bob Loeper Adella Fernandez Lopez Mr. & Mrs. Edward M. Luedtke Mr. & Mrs. Ronald C. Mackenzie Doreen Mallard Michael G. Mayer Kelly Mayo Linda McCann, RD Franklin D. McDonald, MD Thomas P. McDonough William S. McGarrahan Lois & Curtis McGinnis William L. McGuffin, Jr., MD Bob McGuire E. Burns McLindon Carolyn McVitty Alan C. Mendelson James A. Mengler Michael K. Meyer Marie Minchin Stella Mlinarevich Carl A. Modecki Lynn Kanter Moltz Charlie Morse Spero Moutsatsos Greg Muerchen Mary V. Murphy

Lawrence Murphy Timothy R. Neal Miriam M. Netter John H. Newman Fred Nicholas Wayne W. Nix Ray Nowacki J. L. O’Bryan-Wilson David A. Ogden, MD Michael C. O’Grady Daniel B. Ornt Carmen J. Ortiz-Butcher, MD Richard D. Osur Eddie Pannell Irene E. Panush, MSW, ACSW Jean Paris Barbara Parsons Mary Agnes Paul Ronald D. Paul Max & Marcia Perry Thomas G. Peters, MD William W. Petty Jerry L. & Gina Pigsley Robert Plumpe Dann Pollard-Stringer Oliver W. Porter Nancy L. Post Wayne E. Postma Mary E. Powell Robert Provenzano, MD Douglas Ray Roy Re Elizabeth Reder Grace J. Reese Ophie Resor Beverly Ricardo Dorothy Ricenbaw Ivan M. Richards, MD Hank Rosenzweig, CPA Mr. & Mrs. Irving B. Ross Jeanne & Tevis A. Ross Jorena Rudd Dr. & Mrs. Lee M. Russell John G. Ryan Richard K. Salick Phil Salick Harold A. Saul Phillip A. Schermerhorn, Jr. Jonathan Schraub, Esq. Harold D. Schwartz Len Schwartz

Julie Schweitzer James O. Selzer Elizabeth Serge Roohallah Shafely Craig B. Shaffer Glenna Shapiro Mr. & Mrs. Roy Shea Dr. & Mrs. Abraham Sherer Mr. & Mrs. Bill Singleton Linda Smith-Wheelock Gary T. Snyder Phyllis Solof Kathleen Spillane-Knight David P. St. Clair Terrel G. Stanton Arthur J. Stegall, Jr. Grace N. and Gerald V. Steinbaugh Theodore I. Steinman, MD Ann C. Stivers Harry B. & Hilda Sugarman Cynthia J. Terrell Mr. & Mrs. Roy G. Thompson Mr. & Mrs. Andrew Townes, Jr. Mr. & Mrs. Knox Tumlin Joel G. Turner Jay L. Turoff Linda S. Tyler Fusayo Urakami Luis Uribe Mo Vidwans Prudence Vipiani James L. Walden Greg Ward Jack Weaver Betty J. West John E. Wharton Randy Williams Mark E. Williams, MD Henry Wilson Donald R. Wilson Dr. & Mrs. James F. Winchester Deborah Winegard Elizabeth Witten Irv Wolper Suzanne J. Wyckoff David Yoburn Rosemary Zeplowitz Susan Zimmerman Anonymous

LEADERSHIP OFFICERS Chancellor: Ken Howard Los Angeles, California Chairman: Charles B. Fruit Atlanta, Georgia President: David G. Warnock, MD Birmingham, Alabama President Elect: Allan J. Collins, MD Minneapolis, Minnesota Secretary: Robert V. Ogrodnik St. Louis, Missouri Treasurer: Rodney L. Bishop St. Louis, Missouri

DIRECTORS Dear Abby aka Jeanne Phillips Los Angeles, California Stephen T. Bartlett, MD Baltimore, Maryland Deborah I. Brommage, MS, RD Mineola, New York Fred L. Brown, FACHE Scottsdale, Arizona Jeffery H. Burbank Tewksbury, Massachusetts William Cella New York, New York Carl Chaleff Chicago, Illinois

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John Davis New York, New York David A. DeLorenzo Thousand Oaks, California Ellen Gaucher, MSN Des Moines, Iowa John K. Harrison Howell, Michigan

STAFF LEADERSHIP John Davis Chief Executive Officer Stephen Bajardi Chief Operating Officer Joseph Vassalotti, MD Chief Medical Officer

Thomas P. McDonough Bethesda, Maryland

Dolph Chianchiano Senior Vice President for Health Policy and Research

David McLean, PhD St. Paul, Minnesota

Joan Shepard Lustig Vice President for Field Services

Burl Osborne Dallas, Texas

Gigi Politoski Senior Vice President for Programs

Brian J.G. Pereira, MD, DM Boston, Massachusetts William A. Singleton Washington, D.C. Mark E. Smith Richmond, Virginia Martin Starr, PhD Plymouth, Massachusetts Karen Thurman Dunnellon, Florida Pedro J. Vergne-Marini, MD Dallas, Texas Legal Counsel: A. Bruce Bowden, Esq. Pittsburgh, PA

Jo-Ann Vecchione Senior Vice President for Organizational Resources Kerry Willis, PhD Senior Vice President for Scientific Activities Suzanne J. Wyckoff Executive Vice President

NKF AFFILIATES National Kidney Foundation of Alabama, Inc. 334.396.9870

National Kidney Foundation of Indiana, Inc. 317.722.5640

National Kidney Foundation of Northeast New York, Inc. 518.458.9697

National Kidney Foundation of Utah & Idaho, Inc. 801.226.5111

National Kidney Foundation of the Alleghenies, Inc. 412.261.4115

National Kidney Foundation of Iowa, Inc. 319.369.4474

National Kidney Foundation of Upstate New York, Inc. 585.697.0874

National Kidney Foundation of the Virginias, Inc. 804.288.8342

National Kidney Foundation of Arizona, Inc. 602.840.1644

National Kidney Foundation of Kansas & Western Missouri, Inc. 913.262.1551

National Kidney Foundation of Western New York, Inc. 716.835.1323

National Kidney Foundation of Wisconsin, Inc. 262.821.0705

National Kidney Foundation of Northern California and Northern Nevada, Inc. 415.543.3303

National Kidney Foundation of Kentucky, Inc. 502.585.5433

National Kidney Foundation of North Carolina, Inc. 704.552.1351

DIVISIONS:

National Kidney Foundation of Southern California, Inc. 818.783.8153

National Kidney Foundation of Louisiana, Inc. 504.861.4500

National Kidney Foundation of Ohio, Inc. 614.481.4030

National Kidney Foundation of the National Capital Area, Inc. 202.244.7900

National Kidney Foundation of Maine, Inc. 207.772.7270

National Kidney Foundation of South Carolina, Inc. 803.799.3870

National Kidney Foundation of Colorado, Montana & Wyoming, Inc. 720.748.9991

National Kidney Foundation of Maryland, Inc. 410.494.8545

National Kidney Foundation of East Tennessee, Inc. 865.688.5481

National Kidney Foundation of Connecticut, Inc. 860.257.3770

National Kidney Foundation of Massachusetts, Rhode Island, New Hampshire & Vermont, Inc. 781.278.0222

National Kidney Foundation of Middle Tennessee, Inc. 615.383.3887

National Kidney Foundation of the Delaware Valley, Inc. 215.923.8611

National Kidney Foundation of Michigan, Inc. 734.222.9800

National Kidney Foundation of West Tennessee, Inc. 901.683.6185

National Kidney Foundation of Florida, Inc. 407.894.7325

National Kidney Foundation of Mississippi, Inc. 601.981.3611

National Kidney Foundation of North Texas, Inc. 214.351.2393

National Kidney Foundation of Georgia, Inc. 770.452.1539

National Kidney Foundation of Eastern Missouri & Metro-East, Inc. 314.961.2828

National Kidney Foundation of South & Central Texas, Inc. 210.829.1299

National Kidney Foundation of Hawaii, Inc. 808.593.1515

National Kidney Foundation of Nebraska, Inc. 402.572.3180

National Kidney Foundation of Southeast Texas, Inc. 713.952.5499

National Kidney Foundation of Illinois, Inc. 312.321.1500

National Kidney Foundation of Central New York, Inc. 315.476.0311

National Kidney Foundation of West Texas, Inc. 806.799.7753

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National Kidney Foundation Serving the Dakotas and Minnesota The Dakotas 605.322.7025 Minnesota 952.544.7300 National Kidney Foundation Serving Greater New York 212.889.2210

DIRECT SERVICES AREAS*: Arkansas Nevada New Mexico Oklahoma Oregon Texas Coastal Bend Area Washington

* All local programs and services in these areas are provided directly by the National Organization and can be accessed by calling 800.282.0190.

Report of Independent Auditors

National Kidney Foundation, Inc.

Balance Sheet June 30 2006

2005

Cash and cash equivalents

$ 5,004,190

$ 7,557,759

Investments (Note 3)

15,580,868

11,286,563

921,792

817,004

2,203,296

1,863,048

Other receivables (Notes 4 and 8)

645,366

2,197,924

Inventories

548,285

636,309

Prepaid expenses

465,408

833,178

Those standards require that we plan and perform the audit to obtain reasonable assurance about

Fixed assets, at cost, less accumulated depreciation and amortization (Note 5)

570,072

550,412

whether the financial statements are free of material misstatement. We were not engaged to perform

Other assets

34,049

41,564

an audit of the Foundation’s internal control over financial reporting. Our audit included consideration

Total assets

$ 25,973,326

$ 25,783,761

$ 3,162,357

$ 2,998,452

The Board of Directors National Kidney Foundation, Inc.

ASSETS

We have audited the accompanying balance sheet of the National Kidney Foundation, Inc. (the

Investments held under split-interest agreements (Notes 3 and 12)

“Foundation”) as of June 30, 2006, and the related statements of activities, cash flows and functional expenses for the year then ended. These financial statements are the responsibility of the Foundation’s

Due from Affiliates, principally share of affiliate contributions, less allowance for uncollectible amounts of $200,000 in 2006 and 2005

management. Our responsibility is to express an opinion on these financial statements based on our audit. The prior year summarized comparative information has been derived from the Foundation’s 2005 financial statements and, in our report dated September 12, 2005, we expressed an unqualified opinion on these financial statements. We conducted our audit in accordance with auditing standards generally accepted in the United States.

of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the

LIABILITIES AND NET ASSETS

Foundation’s internal control over financial reporting. Accordingly, we express no such opinion. An audit

Accounts payable and accrued expenses

also includes examining, on a test basis, evidence supporting the amounts and disclosures in the finan-

Payable to beneficiaries (Note 12)

369,450

382,790

Funds held in trust (Note 3)

448,035

409,377

Deferred income

4,277,112

4,952,409

Total liabilities

8,256,954

8,743,028

5,601,874

5,842,613

Temporarily restricted (Note 10)

11,940,261

11,023,883

Permanently restricted (Note 11)

174,237

174,237

Total net assets

17,716,372

17,040,733

Total liabilities and net assets

$25,973,326

$ 25,783,761

cial statements, assessing the accounting principles used and significant estimates made by management, and evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the

Commitments (Notes 7 and 9)

financial position of the National Kidney Foundation, Inc. as of June 30, 2006, and the changes in its net assets and its cash flows for the year then ended in conformity with accounting principles generally

NET ASSETS:

accepted in the United States.

Unrestricted

September 12, 2006

44 45

See accompanying notes.

National Kidney Foundation, Inc.

National Kidney Foundation, Inc.

Statement of Activities

Statement of Cash Flows

Year ended June 30, 2006 with summarized financial information for the year ended June 30, 2005 Unrestricted

Temporarily Restricted

Permanently Restricted

2006 Total

Year ended June 30 2006

2005 Total

$ 675,639

$ 3,069,129

Depreciation and amortization

158,808

148,077

Deferred rent

136,304

90,623

SUPPORT, REVENUE AND RECLASSIFICATIONS

Change in net assets

Support from the public:

Adjustments to reconcile change in net assets to net cash provided by operating activities:

Received directly—contributions Received indirectly—share of Affiliate contributions Total support from the public Revenue: Program service support and fees Royalties Dues—professional members Investment income, including net realized and unrealized gain on appreciation of securities of $604,807 in 2006 and $422,140 in 2005 Other, net Gain from settlement of litigation (Note 8) Total revenue and support Net assets released from restrictions (Note 10) Total support, revenue and reclassifications

$ 1,111,169

$ 570,762

$–

$ 1,681,931

$1,333,274

6,774,637





6,774,637

7,539,692

7,885,806

570,762



8,456,568

8,872,966

20,410,066





20,410,066

19,676,768

1,469,665





1,469,665

1,384,298

769,213





769,213

733,819

Write-off of inventory Net realized and unrealized gains on investments Due from Affiliates Other receivables

295,574

1,035,287



1,330,861

1,053,779

16,183





16,183

237,704









2,200,000

30,846,507

1,606,049



32,452,556

34,159,334

(689,671)







31,536,178

916,378



32,452,556

34,159,334



3,006,090

3,030,340

Public health education

4,120,461





4,120,461

3,900,490

Professional education

10,281,072





10,281,072

9,761,647

5,338,221





5,338,221

5,461,476

4,516,656





4,516,656

4,349,260

27,262,500





27,262,500

26,503,213

Fundraising

1,385,691





1,385,691

1,371,271

Management and general

3,128,726





3,128,726

3,215,721

4,514,417





4,514,417

4,586,992

31,776,917





31,776,917

31,090,205

Change in net assets Net assets at end of year

(4,324)

Accounts payable and accrued expenses

27,601

599,989

Payable to beneficiaries

(13,340)

114,082

Funds held in trust

38,658

27,821

(675,297)

(496,839)

1,419,185

2,774,010

(178,468)

(170,649)

Proceeds from sale of investments

2,032,143

7,587,702

Increase (decrease) in liabilities:

Net cash provided by operating activities

Supporting services:

Net assets at beginning of year

7,515

Purchases of fixed assets –

Total expenses

(28,043)

CASH FLOWS FROM INVESTING ACTIVITIES 3,006,090

Total supporting services

135,625 (1,627,443) 1,040,651

Deferred income

Research

Assistance to Affiliates

(340,248) 1,552,558 10,283

Prepaid expenses

Program services:

Total program services

126,802 (422,140)

367,770

Inventories Other assets

689,671

77,741 (604,807)

(Increase) decrease in assets:

EXPENSES

Patient services

2005

CASH FLOWS FROM OPERATING ACTIVITIES

(240,739)

916,378



675,639

3,069,129

5,842,613

11,023,883

174,237

17,040,733

13,971,604

$ 5,601,874

$ 11,940,261

$ 174,237

$ 17,716,372

$ 17,040,733

Purchases of investments

(5,826,429)

(7,506,956)

Net cash used in investing activities

(3,972,754)

(89,903)

Net (decrease) increase in cash and cash equivalents

(2,553,569)

2,684,107

Cash and cash equivalents at beginning of year

7,557,759

4,873,652

$ 5,004,190

$ 7,557,759

$ 250

$ 250

Cash and cash equivalents at end of year SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION Unrelated business income taxes paid

See accompanying notes.

See accompanying notes.

46 47

National Kidney Foundation, Inc.

National Kidney Foundation, Inc.

Statement of Functional Expenses

Notes to Financial Statements June 30, 2006

Year ended June 30, 2006 with summarized financial information for the year ended June 30, 2005 PROGRAM SERVICES

Research

Public Health Education

Professional Education

TOTAL PROGRAM AND SUPPORTING SERVICES

SUPPORTING SERVICES

Patient Services

Assistance to Affiliates

Total

FundRaising

Management and General

1. ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Total

2006

2005

$274,893

$779,568

$980,783

$1,033,281

$1,706,351

$4,774,876

$665,966

$1,351,586

$2,017,552

$6,792,428

$6,555,678

Employee benefits

49,640

148,919

173,739

186,149

410,198

968,645

124,099

270,615

394,714

1,363,359

1,286,427

Payroll taxes

18,912

56,735

66,191

70,919

118,198

330,955

47,279

94,559

141,838

472,793

514,247

2,446,783









2,446,783







2,446,783

2,474,529

19,973

67,474

512,296

81,579

213,031

894,353

48,267

257,939

306,206

1,200,559

1,717,042

29,960

131,950

138,802

143,785

122,226

566,723

42,065

99,277

141,342

708,065

457,111

Salaries

Awards and grants (Note 9) Professional fees and contract services Office supplies and expenses

8,087

18,961

21,789

23,148

36,630

108,615

16,432

30,023

46,455

155,070

157,210

Postage and shipping

10,823

110,556

44,364

118,764

59,553

344,060

24,844

48,057

72,901

416,961

381,827

Building occupancy

45,063

135,190

157,722

168,987

281,646

788,608

112,657

225,317

337,974

1,126,582

983,151

Telephone

Insurance

2,903

6,968

7,984

8,492

113,465

139,812

6,014

11,096

17,110

156,922

136,941

Printing and publications Meetings and travel— volunteers

2,990

145,909

578,478

133,373

2,990

863,740

3,204

12,230

15,434

879,174

1,041,554









225,183

225,183



212,614

212,614

437,797

499,571

Meetings and travel—staff

20,992

121,722

123,006

129,433

190,125

585,278

41,109

95,752

136,861

722,139

704,938

Meetings and travel—medical

10,485

12,587

83,048

129,244



235,364



750

750

236,114

82,457

Transplant games



773,762



773,762



1,547,524







1,547,524

2,252,863

Special projects programs



1,571,393

7,218,251

2,352,400

479,847

11,621,891

73,011

366,359

439,370

12,061,261

10,909,433

Special projects marketing



148,133





486,111

634,244

148,133



148,133

782,377

796,488

Subscriptions and publications



21,697



11,499



33,196

10,198



10,198

43,394

39,385

Direct assistance to patients







79,005



79,005







79,005



Membership dues and support

15,033

15,033

15,033

15,033



60,132







60,132

62,245

Miscellaneous expenses

34,069

43,853

109,720

61,360

48,885

297,887

15,410

36,131

51,541

349,428

436,782

2,990,606

4,310,410

10,231,206

5,520,213

4,494,439

27,546,874

1,378,688

3,112,305

4,490,993

32,037,867

31,489,879

15,484

19,930

49,866

27,887

22,217

135,384

7,003

16,421

23,424

158,808

148,077

3,006,090

4,330,340

10,281,072

5,548,100

4,516,656

27,682,258

1,385,691

3,128,726

4,514,417

32,196,675

31,637,956



(209,879)



(209,879)



(419,758)







(419,758)

(547,751)

$3,006,090

$4,120,461

$10,281,072

$5,338,221

$4,516,656

$ 27,262,500

$1,385,691

$3,128,726

$4,514,417

$31,776,917

$31,090,205

Current year’s percentages

9.46%

12.97%

32.35%

16.80%

14.21%

85.79%

4.36%

9.85%

14.21%

100.00%



Last year’s percentages

9.75%

12.55%

31.40%

17.56%

13.99%

85.25%

4.41%

10.34%

14.75%



100.00%

Depreciation and amortization

Less cost of sales Total expenses reported by function in the statement of activities

See accompanying notes.

The National Kidney Foundation, Inc. (the “Foundation”), headquartered in New York City, has chartered a network of Affiliates and Divisions across the country to implement its mission to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases and increase the availability of all organs for transplantation. Founded in 1950 to address the critical impact of these diseases, the Foundation conducts nationwide educational campaigns about the role of the kidney in maintaining overall health, the importance of early detection and organ donation and transplantation. The Foundation maintains a Washington office to represent the needs of its constituents by advocating for research and coverage of medications needed by those with kidney failure, and also supports an extensive scientifically meritorious research program. The Foundation’s office in Kansas City provides services and assistance to all Foundation Affiliates regarding organizational and fund-raising matters. Under the provisions of a charter with the Foundation, each Affiliate must meet certain requirements regarding organizational structure, program services and fund-raising.

COMPONENTS OF PROGRAM SERVICES Research The Foundation sponsors research that seeks answers to key questions relating to kidney disease. Grants are provided for studies aimed at finding treatments or to prevent kidney disease as well as to improve the quality of life and long term outlook for people with chronic kidney disease.

Public Health Education The Foundation’s public health education efforts strive to teach the public about kidney related issues such as causes of kidney disease and the importance of early detection. These efforts are made through the disbursement of educational brochures to the public, on-line health guides on the Foundation’s Web site and through media outreach.

Professional Education

The Foundation provides consultation, guidance, training and leadership to its Affiliates and other organizations. Specific guidance is provided with informational booklets that cover issues such as patient transportation programs, drug and blood banks, and screening and detection programs.

Fund Accounting and Net Asset Classifications To ensure observance of limitations and restrictions placed on the use of resources available to the Foundation, the Foundation’s accounts are maintained in accordance with the principles of fund accounting. Separate accounts are maintained for each fund; however, in the accompanying financial statements, funds that have similar characteristics have been combined into three net asset classes: unrestricted, temporarily restricted and permanently restricted. Unrestricted Net Assets: Unrestricted net assets include expendable resources over which the Foundation’s Board of Directors has discretionary control and are used to carry out the Foundation’s operations in accordance with its bylaws. Included in unrestricted net assets are funds used to account for fixed asset acquisitions, improvements and related activities. Temporarily Restricted Net Assets: Temporarily restricted net assets include resources expendable only for those purposes specified by the donor or grantor. The restrictions are satisfied either by the passage of time or by actions of the Foundation. Permanently Restricted Net Assets: Permanently restricted net assets include resources subject to donor-imposed stipulations that they be maintained permanently by the Foundation.

Support and Revenue Grants and contributions are recorded as revenue when received or pledged unconditionally, at fair value. Contributions received with donor stipulations that limit the use of the donated assets are reported as temporarily restricted support. When a donor restriction expires, that is, when a time restriction ends or purpose restriction is fulfilled, temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions.

Due from Affiliates and Share of Affiliate Contributions

Patient Services

The Foundation and its Affiliates have agreements under which a portion of contributions received by Affiliates is shared with the Foundation. Amounts received but not remitted by Affiliates are recorded by the Foundation as due from Affiliates. The Affiliates’ share of contributions solicited by Affiliates and received directly by the Foundation is credited to Affiliate receivables.

The patient services programs include initiatives to improve patients’ health and quality of life. Programs include the development of evidence-based practice guidelines for kidney disease treatment, free screening for individuals at risk through the Kidney Early Evaluation Program and patient empowerment programs that encourage patients to take charge of their own health care.

From time to time, the Foundation makes cash advances or short-term loans to various Affiliates for the purpose of funding operations. The loans are interest bearing (at approximately 5% per annum) and repayable based on mutually agreeable terms. These advances and short-term loans are included in due from Affiliates in the accompanying balance sheet.

The Foundation’s program provides professionals with tools needed to provide optimum patient care. Products provided include toolkits, best practices, medical journals, and professional education conferences.

48 49

Program Assistance to Affiliates

Notes to Financial Statements (continuation)

Notes to Financial Statements (continuation) 1. ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued)

Expense Allocations The majority of expenses can generally be directly identified with program or supporting services to which they relate and are allocated accordingly. Other expenses have been allocated among program and supporting service classifications primarily on the basis of the employees’ time allocations or other methods determined by management.

Deferred Income Deferred income consists primarily of amounts received in advance for contracted programs, membership dues and journal subscriptions that apply to future periods. Membership dues and subscription revenue are recognized as revenue over the respective membership and subscription periods. Revenues and expenses related to contracted programs are recognized upon progression of the program in accordance with the applicable agreement.

Donated Services The Foundation’s volunteers, comprised of physicians, allied health professionals, business and community leaders, kidney patients and their families, and others committed to the Foundation’s mission, have made significant contributions of their time to the Foundation’s programs and supporting services. The value of such volunteers’ services has not been reflected in the accompanying financial statements as it does not meet the criteria for revenue recognition established by Statement of Financial Accounting Standards No. 116, Contributions Received and Contributions Made.

Cash and Cash Equivalents The Foundation considers highly liquid financial instruments, excluding cash held in trust or held as part of the investment portfolio, with maturities of three months or less when purchased to be cash equivalents.

Inventories Inventories, which consist of educational publications in print and on CD-ROM, are stated at the lower of cost or market determined by the first-in, first out method.

Investments and Investment Income The Foundation carries investments in marketable equity securities (including equity funds) with readily determinable fair values and all investments in debt securities at their fair values in the accompanying balance sheet. Fair values are based on quoted market prices. Income earned from investments, including realized and unrealized gains and losses, is recorded in the net asset class owning the assets with the exception of permanently restricted net assets. Income earned from permanently restricted investments, including realized and unrealized gains and losses, is recorded as temporarily restricted for purposes specified by the donor.

Fixed Assets Fixed assets are stated on the basis of cost or, as to donated assets, fair value on the date donated. Depreciation is com-

4. CONTRIBUTIONS RECEIVABLE

puted by the straight-line method over the estimated useful lives of the assets. Leasehold improvements are amortized over the shorter of the remaining period of the lease or their estimated useful lives.

Included in the above are assets held under split-interest agreements in the amount of approximately $922,000 and $817,000 at June 30, 2006 and 2005, respectively (see Note 12).

Summarized Financial Information

At June 30, 2006 and 2005, investments include amounts held in trust of approximately $448,000 and $409,000, respectively.

The accompanying financial statements include certain prior year summarized comparative information in total but not by net asset class. Such information does not include sufficient detail to constitute a presentation in conformity with accounting principles generally accepted in the United States. Accordingly, such information should be read in conjunction with the Foundation’s financial statements for the year ended June 30, 2005 from which the summarized information was derived.

At June 30, 2006 and 2005, $11,350,362 and $10,690,027, respectively, of the investments relate to temporarily restricted research endowment funds. Included in other receivables are contributions receivable which represent unconditional promises to give. At June 30, 2006 and 2005, these contributions receivable, with the noncurrent portion discounted (at a rate of 6%) to present value, are due to be collected as follows:

Use of Estimates The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Within one year One to five years Discount to present value

Reclassification

(9,810)

(16,047)

$ 80,190

$ 103,953

Furniture and equipment, leasehold improvements, capitalized software and accumulated depreciation and amortization as of June 30, 2006 and 2005 are as follows:

2. TAX-EXEMPT STATUS The Foundation is a not-for-profit voluntary health agency as described in Section 501(c)(3) of the Internal Revenue Code (the “Code”). The Foundation is exempt from Federal income taxes under Section 501(a) of the Code and has been classified as a publicly supported charitable organization under Section 509(a)(1) of the Code. The Foundation also is exempt from New York State and City income taxes. Contributions to the Foundation are deductible for income tax purposes to the maximum extent allowed under the Code.

Furniture and equipment Leasehold improvements Capitalized software

$ 2,393,069

$ 1,911,026

4,345,031

4,226,598

5,637,006

5,139,542

901,369

806,122

3,226,185

20,279

$ 16,502,660

$ 12,103,567

779,061

620,253

$ 570,072

$ 550,412

The Foundation has a contributory retirement/savings plan. The plan covers substantially all full-time employees who meet certain age and service requirements. Under the terms of the plan, contributions are made under Section 403(b) of the Code and are invested, at the discretion of the plan participant, in one or more of the investment vehicles available under the plan. Pension expense for the years ended June 30, 2006 and 2005 amounted to approximately $700,000 and $540,000, respectively.

Fair Value 2005

2005 $ 929,629 175,940 65,096 1,170,665

6. RETIREMENT/SAVINGS PLAN

The fair value of investments and investments held under split-interest agreements at June 30, 2006 and 2005 consisted of the following: 2006

2006 $ 1,060,906 210,662 77,565 1,349,133

Less accumulated depreciation and amortization

3. INVESTMENTS

Small cap stock fund Cash and U.S. Government securities

2005 $ 30,000 90,000

5. FIXED ASSETS

Certain amounts in the 2005 financial statements have been reclassified to conform to the 2006 presentation.

International equity fund Fixed income securities fund iShares index funds

2006 $ 30,000 60,000

50 51

During fiscal 2006, the Foundation adopted a Section 457(f) Senior Staff Flexible Benefit Plan (the “Plan”), that provides highly compensated employees with a benefit allowance contributed by the Foundation, which can be used for various benefit options, including a capital accumulation account. Benefit expense related to the Plan totaled approximately $63,000. The fully funded liability related to the plan amounted to approximately $45,000 at June 30, 2006 and is included in accounts payable and accrued expenses in the accompanying balance sheet.

During fiscal 2006, the Foundation also adopted a Section 457(f) Supplemental Executive Retirement Plan (SERP) for one key employee. Benefit expense related to the SERP totaled approximately $90,000. The fully funded liability related to the plan amounted to approximately $90,000 at June 30, 2006 and is included in accounts payable and accrued expenses in the accompanying balance sheet. 7. COMMITMENTS The Foundation occupies premises under noncancelable operating leases in effect through 2019. Under the terms of these operating leases, rental payments increase annually. However, for financial statement purposes, rent expense is recorded on the straight-line basis over the term of the lease. The difference between rental payments made under the lease and rent expense calculated on the straight-line basis is recorded as deferred rent. At June 30, 2006 and 2005, deferred rent of approximately $227,000 and $91,000 is reflected in accounts payable and accrued expenses in the accompanying balance sheet. Rent expense approximated $1,127,000 and $953,000 for the years ended June 30, 2006 and 2005, respectively. Approximate future minimum lease payments are as follows: 2007 2008 2009 2010 2011 Thereafter

$ 849,000 838,000 857,000 877,000 897,000 9,261,000 $ 13,579,000

The Foundation has a line of credit not to exceed $1,000,000 at June 30, 2006. At June 30, 2006, there was no balance outstanding under this credit line. 8. GAIN FROM SETTLEMENT OF LITIGATION The gain on settlement of litigation recognized during the year ended June 30, 2005 relates to a settlement reached with a former Affiliate. 9. AWARDS AND GRANTS As of June 30, 2006 and 2005, the Foundation has entered into conditional multi-year research grant commitments. The Foundation recognizes as expense the portion of the research grant award that is unconditional in the year it becomes unconditional. The Foundation has expensed research grants of approximately $2,447,000 and $2,475,000 for the years ended June 30, 2006 and 2005, respectively. The outstanding commitments for research projects, which are conditional at June 30, 2006, are scheduled for funding approximately as follows: fiscal 2007—$1,208,000 and fiscal 2008—$150,000. These projects will be funded by unrestricted and certain temporarily restricted net assets and support and revenue to be generated by the Foundation.

Notes to Financial Statements (continuation)

National Kidney Foundation and Its Affiliates

10. TEMPORARILY RESTRICTED NET ASSETS

12. SPLIT-INTEREST AGREEMENTS

Combined Balance Sheet (unaudited)

Temporarily restricted net assets are restricted for the following purposes at June 30, 2006 and 2005:

The Foundation receives contributions under charitable gift annuities. The Foundation has segregated these assets as separate and distinct funds, independent from other funds and not to be applied to payment of the debts and obligations of the Foundation or any other purpose other than annuity benefits specified in the agreements. In addition, this portfolio of assets meets all requirements concerning permissible investments and mandated reserves as required by law. The Foundation agrees to pay a stated return annually to the beneficiaries as long as they live, at which time the remaining assets are available for unrestricted use of the Foundation.

Research endowment funds Transplantation guidelines Transplant gamestravel support Enuresis research Other programs

2006

2005

$ 11,430,552

$ 10,793,980

423,540

158,275

9,593

35,413

38,356 38,220 $ 11,940,261

20,005 16,210 $ 11,023,883

Temporarily restricted net assets were released from restrictions in fiscal 2006 and 2005 as follows: Research endowment funds Other research Other programs

2006 $446,146 152,483 91,042 $689,671

2005 $497,704 203,367 13,290 $714,361

11. PERMANENTLY RESTRICTED NET ASSETS Permanently restricted net assets consist of investments that are to be held in perpetuity with income therefrom available to support clinical research in enuresis.

as of June 30, 2006

ASSETS Cash and Cash Equivalents Investments Accounts Receivable Inventories of Educational & Campaign Material

At June 30, 2006 and 2005, the total assets held under split-interest agreements were approximately $922,000 and $817,000, respectively, at fair value. The actuarial present value of the Foundation’s payable to beneficiaries was approximately $369,000 and $383,000 at June 30, 2006 and 2005, respectively, and was calculated using interest rates ranging from 5% to 6%. Certain Affiliates have a beneficial interest in the expected cash value of the gift annuities, which was approximately $162,000 and $159,000 as of June 30, 2006 and 2005, respectively, and is included in accounts payable and accrued expenses in the accompanying balance sheet.

38,673,865 6,785,932 609,515

Prepaid Expenses

1,007,570

Property, Plant & Equipment, at cost

9,510,576

Less Accumulated Depreciation

(4,738,021)

Property, Plant & Equipment, net

4,772,555

Other Assets

1,199,823

Total Assets

$75,233,650

Liabilities

1. Accounting Standards

3. Composition of Financial Statements

The Foundation follows the standards of accounting and reporting for voluntary health and welfare agencies developed by the National Health Council and National Social Welfare Assembly.

The accompanying combined financial statements have been prepared by the National Office from the individual financial reports of each Affiliate and are not covered by the report of Ernst&Young LLP. Each of the individual Affiliate financial statements has been audited by other auditors as a separate entity, and those reports are available from the Affiliate upon request.

Loans Payable

$698,208

Accounts Payable & Accrued Expenses

5,878,862

Deferred Income

5,145,954

Other Liabilities

839,890

Total Liabilities

Combined Financial Statements (unaudited)

Expenses have been allocated to various classifications by using time records and management’s estimation.

$22,184,390

LIABILITIES & NET ASSETS

National Kidney Foundation, Inc.

2. Functional Expenses

2006

12,562,914

Net Assets Unrestricted

39,359,456

Temporarily Restricted

20,682,890

Permanently Restricted Total Net Assets Total Liabilities and Net Assets

Note: Figures from the NKF of Arkansas, Oklahoma and Texas Coastal Bend were not received when this Annual Report went to press.

52 53

2,628,390 62,670,736 $75,233,650

National Kidney Foundation and Its Affiliates

National Kidney Foundation and Its Affiliates

Combined Statement of Activities (unaudited)

Combined Statement of Cash Flow (unaudited)

For the Year Ended June 30, 2006

For the Year Ended June 30, 2006 UNRESTRICTED

TEMPORARILY RESTRICTED

PERMANENTLY RESTRICTED

TOTAL 2006

2006 CASH FLOWS FROM OPERATING ACTIVITIES:

SUPPORT, REVENUE AND RECLASSIFICATIONS

Change in Net Assets

Support from the Public:

Adjustments to Reconcile Change in Net Assets to Net Cash

Received Directly:

Provided by Operating Activities: $23,633,886

$4,500,796

$71,095

$28,205,777

Special Events Revenue

21,572,250

499,539

0

22,071,789

Less: Direct Benefit Costs

(10,054,612)

(150,891)

0

(10,205,503)

Net Support from Special Events

11,517,638

348,648

0

11,866,286

Contributions

Depreciation and Amortization Unrealized Gain/Loss on Investments Loss on Disposal of Fixed Assets Donated Stocks

Received Indirectly: United & Federated Funds

900,523

234,059

0

1,134,582

Combined Federal Campaign

435,928

47,628

0

483,556

36,487,975

5,131,131

71,095

41,690,201

3,688,435

294,312

0

3,982,747

Total Support from the Public Government Grants

Donated Fixed Assets

Membership Dues Sale of Literature & Drugs (net of expense) Investment Income

Accounts Receivable

1,114,314

0

22,764,733

839,981

0

0

839,981

Inventories of Educational & Campaign Material Prepaid Expenses

483,747

Other Assets

518,164

430,409

9,607

0

440,016

1,843,192

1,164,342

0

3,007,534

0

0

10,714,404

Accounts Payable & Accrued Expenses

0

(14,030,350)

Deferred Income

Net Sales of Donated Vehicles

(3,315,946)

0

0

(3,315,946)

Miscellaneous Revenue

2,236,129

0

0

2,236,129

Total Other Revenue

23,684,184

2,288,263

0

25,972,447

Total Support and Other Revenue

63,860,594

7,713,706

71,095

71,645,395

7,005,000

(7,005,000)

0

0

$70,865,594

$708,706

$71,095

$71,645,395

Other Liabilities Net Cash Provided by Operating Activities Purchase of Fixed Assets Proceeds from the Disposition of Fixed Assets Proceeds from the Sale of Investments

Program Services: $5,089,177

$5,089,177

Public Health Education

11,774,669

11,774,669

Professional Education

13,533,889

13,533,889

Patient Services

16,832,216

16,832,216

9,668,306

9,668,306

56,898,257

56,898,257

Management and General

Total Expenses Change in Net Assets Net Assets at the Beginning of the Year, as Restated Net Assets at the End of the Year

$69,262,378

$69,262,378

1,603,216

708,706

71,095

2,383,017

37,756,240

19,974,184

2,557,295

60,287,719

$39,359,456

$20,682,890

$2,628,390

$62,670,736

9,615,303 (3,191,355)

Contributions to Endowment

71,095

Proceeds from Loans Payable

144,328

Repayment of Loans Payable

(50,060)

Net Cash Used in Financing Activities

Cash and cash equivalents at end of year

6,105,160 12,364,121

(687,588) 2,182,364

Net cash Used in Investing Activities

Cash and cash equivalents at beginning of year, as restated

6,105,160

(89,889) 2,470,678

(14,301,433)

6,258,961

12,364,121

(538,526)

CASH FLOWS FROM FINANCING ACTIVITIES:

Supporting Services:

Total Supporting Services

(1,418,514)

Purchases of Investments

Net increase/(decrease) in cash and cash equivalents 6,258,961

61,157

CASH FLOWS FROM INVESTING ACTIVITIES:

EXPENSES

Fund-raising

2,127,000

21,650,419

0

Total Program Services

136,304

CHANGES IN OPERATING ASSETS AND LIABILITIES (AS RESTATED):

10,714,404

Community Services

(54,700) (414,885) 10,714,404

(14,030,350)

Research

(39,555)

(10,709,808)

Sales of Donated Vehicles

Total Support, Revenue and Reclassifications

(1,280,234)

Cost of Sales of Contributed Vehicles

Less: Cost of Sales & Selling Expenses

Net Assets Released From Restrictions

592,996

Contribution of Vehicles Deferred Rent

Other Revenue: Program Service Fees

$2,383,017

165,363 (555,314) 22,739,703 $22,184,390

SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION Interest paid Income taxes paid

54 55

Noncash investing and financing activities-in-kind donations

20,378 250 722,714

National Kidney Foundation and Its Affiliates

Combined Statement of Functional Expenses (unaudited) For the Year Ended June 30, 2006 PROGRAM SERVICES

Public Health Education

Research Salaries Employee Benefits

Professional Education

SUPPORTING SERVICES

Patient Services

Community Services

Fund-raising

Mgt & General

Total Expenses

$739,383

$4,352,738

$2,202,477

$4,637,361

$4,229,290

$2,498,876

$2,635,411

$21,295,536

100,624

616,021

323,673

681,171

750,296

377,785

442,675

3,292,245

57,920

350,327

166,001

373,050

319,878

205,585

209,666

1,682,427

Awards and Grants

3,608,969

378,472

95,828

198,184

41,658

12,499

3,201

4,338,811

Professional Fees & Contract Services

93,776

482,241

757,908

485,452

411,392

289,626

664,883

3,185,278

-

-

-

4,285,763

-

-

-

4,285,763

58,317

327,797

298,839

468,832

276,379

202,242

212,088

1,844,494

Payroll Taxes

Assistance to Patients Office Supplies and Expenses Telephone

28,685

120,450

60,470

120,227

105,814

76,259

70,010

581,915

Postage and Shipping

21,195

202,952

88,174

211,898

127,107

189,774

90,320

931,420

133,303

596,507

478,580

665,748

604,806

348,260

412,833

3,240,037

8,672

39,643

21,107

48,091

144,786

32,029

47,409

341,737

Printing, Publication and Audio-Visual

25,567

396,916

671,594

266,385

145,154

343,444

82,319

1,931,379

Meetings, Symposia and Related Travel

57,274

346,284

563,430

574,544

687,503

221,748

436,752

2,887,535

Membership dues and Subscriptions

16,184

50,245

20,052

40,279

9,120

19,458

16,758

172,096

Miscellaneous Expenses

49,524

307,093

218,253

415,295

139,887

69,728

240,804

1,440,584

-

-

10,205,503

-

10,205,503

Building Occupancy Insurance

Unallocated Direct Benefit Costs Depreciation and amortization

42,726

163,857

101,471

197,057

115,217

64,348

90,184

774,860

Special Projects

13,826

3,123,969

7,428,209

3,370,480

1,493,761

569,883

426,599

16,426,727

Promotion Costs

33,232

129,036

37,823

86,828

66,258

45,383

23,248

421,808

Donated Vehicles Cost of Sales

-

-

-

-

-

-

10,714,404

10,714,404

Donated Vehicles Service Providers

-

-

-

-

-

692,034

3,315,946

4,007,980

Total expenses

$5,089,177

$11,984,548

$13,533,889

$17,126,645

$9,668,306

$16,464,464

$20,135,510

$94,002,539

$-

$-

$-

$10,205,503

$-

$10,205,503

Cost of Sales

-

209,879

-

294,429

-

-

Cost of Sales / Selling Expenses Donated Vehicles

-

-

-

-

-

-

14,030,350

14,030,350

$5,089,177

$11,774,669

$13,533,889

$16,832,216

$9,668,306

$6,258,961

$6,105,160

$69,262,378

7.3%

17.0%

19.5%

24.4%

14.0%

9.0%

8.8%

100.0%

Less: Expenses Netted with Revenues on the Statement of Activities: Direct Expenses of Special Events

Total Expenses Reported by Function Percentages

504,308

MORE THAN 20 MILLION AMERICANS—ONE IN NINE ADULTS— HAVE CHRONIC KIDNEY DISEASE, AND MOST DON’T EVEN KNOW IT. MORE THAN 20 MILLION OTHERS ARE AT INCREASED RISK. THE NATIONAL KIDNEY FOUNDATION, A MAJOR VOLUNTARY HEALTH ORGANIZATION, SEEKS TO PREVENT KIDNEY AND URINARY TRACT DISEASES, IMPROVE THE HEALTH AND WELL-BEING OF INDIVIDUALS AND FAMILIES AFFECTED BY THESE DISEASES, AND INCREASE THE AVAILABILITY OF ALL ORGANS FOR TRANSPLANTATION. THROUGH ITS AFFILIATES AND DIVISIONS NATIONWIDE, THE FOUNDATION CONDUCTS PROGRAMS IN RESEARCH, PROFESSIONAL EDUCATION, PATIENT AND COMMUNITY SERVICES, PUBLIC EDUCATION AND ORGAN DONATION.

MAKING HEADLINES

In 2006 the NKF Generated 265,529,182 Total Media Impressions