It’s Time to Address the Public Health Threat of Chronic Kidney Disease | Commentary

Posted April 1, 2014 at 3:59pm

Chronic kidney disease came as a surprise to Nancy Vice of Warminster, Pa. Severe, unexplained back pain at age 27 sent her to the hospital, where she received her diagnosis and learned she would immediately have to begin dialysis or receive a kidney transplant. Her mother donated a kidney, and Nancy had five years of good health until the transplant failed. For the past 17 years, she has relied on dialysis to survive.

Until she became ill, she didn’t think much about her kidneys. “Before kidney disease, I didn’t know the important role my kidneys played in keeping me healthy and alive. Kidney disease completely blindsided me and changed the course of my life. I wouldn’t wish this on anyone else,” she says.

March was National Kidney Month and Nancy was one of scores of patients and caregivers who visited Capitol Hill to draw attention to the impact of chronic kidney disease on our nation’s health. It’s an impact that is difficult to overstate. At least 26 million Americans are living with chronic kidney disease, and millions more are at risk. More than 600,000 are living with kidney failure and are being treated with dialysis or transplantation.

The time to address this public health threat is now. Congress can take action by protecting federal funding for kidney programs and activities, despite a challenging budget environment.

Many conditions can affect the kidneys, but diabetes and high blood pressure are the two main causes of chronic kidney disease — they are responsible for up to two-thirds of cases. Others at risk include people with a family history of kidney failure, members of minority populations and seniors.

Because chronic kidney disease has no symptoms in its early stages, the vast majority of people with early kidney disease don’t know they have it. Early detection and treatment is the key to slowing the progression of kidney disease. As Nancy puts it, “If I can just get one person to go to the doctor and get their kidneys checked, I will be happy.”

If chronic kidney disease progresses, it can lead to kidney failure, heart attack, stroke and death. In fact, kidney disease is the nation’s ninth leading cause of death. There are many health screening and education programs nationwide that are reaching thousands of at-risk people annually, but sustained federal support is critical to making a lasting difference.

We urge the government to invest in early detection and research to prevent kidney disease progression. This is the way to save health care costs incurred by both Medicare and private insurance companies. Screening and education are inexpensive, as compared to treatment of end-stage kidney failure which costs the federal government more than $30 billion annually.

The Chronic Kidney Disease Program at the Centers for Disease Control and Prevention helps reduce the burden of chronic kidney disease through early detection and treatment programs aimed at high-risk populations. Since 2006, Congress has provided direct funding for a chronic kidney disease program within the CDC’s Division of Diabetes Translation at approximately $2 million per year. To enable the CDC to continue to identify people at high risk of chronic kidney disease and track its progression, it is critical that Congress maintain funding at the current levels for fiscal year 2015.

Just as important as early detection is ensuring that people who are living with kidney failure have access to quality care. Dialysis providers require adequate reimbursement to continue providing quality care to patients, who depend on regular dialysis treatment to survive. Medicare payments to dialysis providers have sustained a series of cuts in recent years. Most recently, the Centers for Medicare and Medicaid Services implemented a 12 percent cut to dialysis provider payments, to be phased in over the next several years. It is critical that there are no more cuts to this program, and that the payment reductions be implemented in a way that does not harm patient care.

With early detection and treatment, and access to quality care, millions of Americans can live healthier lives in the face of chronic kidney disease. Congress plays a critical role in this effort. Protecting federal funding for kidney programs and activities should be high on lawmakers’ agendas, because doing so will lead to a much healthier nation.

LaVarne A. Burton is president and CEO of the American Kidney Fund. Bruce Skyer is CEO of the National Kidney Foundation.