Industry professionals attend conferences to network, learn, connect with peers and, now, thanks to smartphone-based diagnostic tests, they get can important health screenings, too.
At the Congressional Black Caucus Foundation’s annual legislative conference in Washington, D.C., last week, the National Kidney Foundation (NKF) hosted a campaign and on-site testing to raise awareness about the disproportionate impact of chronic kidney disease (CKD) on Black individuals.
Thirty-seven million people in the U.S. are at risk of developing CKD. It's the eighth leading cause of death in the U.S., and nine out of 10 of those affected don’t know they have it. Two of the biggest risk factors are diabetes and hypertension.
If left untreated, CKD can quickly turn into end stage renal disease and require dialysis.
“Most people do not know they have kidney disease because it is asymptomatic. There are no symptoms until you reach advanced stages, and that is why so many people crash onto dialysis,” Morgan Reid, senior director of transplant policy and strategy at NKF, said on a panel at the event.
The incidence of diabetes and hypertension is disproportionately high in the Black population, Jesse Roach, M.D., senior vice president of government relations at NKF, told Fierce Healthcare. Moreover, Black patients are four times more likely to develop chronic kidney disease than white patients, likely because of under-testing and less access to healthcare, he said.
NKF aims to detect and treat kidney disease early, achieve equity in kidney disease treatment, ensure all patients have access to transplants and promote innovation related to kidney disease, Roach said.
Once a patient is in kidney failure, their treatment options are dialysis or kidney transplant. But Roach said Black patients are offered these treatments, associated with higher quality of life, at a lower rates than white patients.
CKD can be prevented, but only if it is identified early. “Black patients sort of get the short end of the stick when it comes to the incidence of kidney failure and the access to the best treatment,” Roach explained.
Black patients are also disproportionately steered to in-office dialysis rather than at-home dialysis, which is gentler on the body and has been linked to improved mental health, the NKF asserts. The foundation is pushing a bill in Congress that would increase access to transplants and at-home dialysis, which the organization says have been senselessly restricted for Black patients.
The bill, the Improving Access to Home Dialysis Act, would mandate providers to have multiple conversations with dialysis patients about all of their dialysis options. The conversations cannot be limited to an emergency setting. The bill would also get more clinical staff trained on at-home dialysis and offer an additional payment for assisted at-home dialysis.
High risk patients are not often tested for CKD. A 2021 study by the Johns Hopkins Bloomberg School of Public Health found that 4.1% of diabetes patients and 35.1% of hypertension patients received a urine test for kidney disease. The researchers also found that the testing that was done was not related to the amount of risk the patient had.
Reid cited a different 2021 study done in collaboration with NKF that found that, on average, only 20% of at-risk patients receive CKD testing.
NKF partnered with Healthy.io to give out 250 free kidney disease tests at the Congressional Black Caucus Foundation’s conference.
Healthy.io offers a chronic kidney disease test that high-risk patients can take at home and get results within minutes. Patients are then encouraged to contact their doctor to discuss the results and undergo additional testing if necessary.
Healthy.io offers the only FDA-cleared, smartphone-powered at-home kidney test that allows patients to take the test in the privacy of their homes and receive immediate clinical-grade results. The company says its at-home urinalysis services enable providers and healthcare systems to reach high-risk, previously untested individuals and help close care gaps.
“This is a real health equity issue,” Geoff Martin, the CEO of Healthy.io, said. “This is a crisis in America from a diagnosis standpoint, and there needs to be innovation in this space as well as there needs to be better aligned incentives that incentivize screening and testing, where we can get people diagnosed earlier in the process and ultimately lead to a better outcome.”
The company is also trying to make the push for more at-risk patients to get screened for CKD.
NKF and Healthy.io are pushing to get a screening recommendation for CKD by the U.S. Preventative Services Task Force.
Roach said the proposal has been turned down in the past because the evidence was not strong enough, though Roach contends that the evidence requirements were too strict. There are currently more studies underway to generate evidence.
NKF also wants more quality measurement for kidney disease in Medicare and Medicaid. Health plans use quality measurement to determine the quality of care being provided to a patient. There is a measure for the link between kidney disease and diabetes, but NKF wants to extend the measure to link hypertension to kidney disease. They also want the measure factored into the Centers for Medicare & Medicaid Services’ star ratings the Healthcare Effectiveness Data and Information Set.
NKF also is working with various agencies to decrease the number of kidneys that are discarded. The foundation wants to decrease the barriers to living donation. Black and Hispanic patients give living donations at a lower rate than other races, partly because of the barriers to donation, which includes taking time off work, experts say.