Congress, the administration, and the kidney community could dramatically transform kidney care

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Americans with kidney disease are living longer, healthier lives thanks to the hard work and collaboration of the entire kidney community. Over the last decade, we have been proud to work together to improve quality, access, and choice for individuals suffering from kidney disease and kidney failure. From increasing the patient survival rate in the first year following kidney failure after transitioning onto dialysis care by 25 percent to improving care so that an additional 135,000 End Stage Renal Disease (ESRD) patients stayed out of the hospital, our community has made significant strides.

Yet despite the gains, much more must be done to address America’s kidney disease epidemic, which affects more than 30 million Americans, including more than 700,000 Americans who suffer from ESRD, an irreversible condition that requires patients to undergo dialysis or receive a  kidney transplant in order to live. With kidney disease ranked as the ninth most common cause of death in the U.S., according to the Centers for Disease Control and Prevention, our community’s continuous efforts to save lives, improve care, and build impactful public-private partnerships is critical. But to aggressively tackle this disease epidemic, we need bold, transformational policies to truly stem the tide.

That is why we welcome President Donald Trump’s recent executive order to increase focus and investment on the kidney disease epidemic nationwide. Specifically, the executive order sets ambitious goals to further lower the mortality rate for patients, prevent at-risk patients from developing ESRD, improve patients’ quality of life and choices in care, and expand access to lifesaving transplants. To achieve these aims, the administration will launch a multifaceted approach that offers opportunities for the entire kidney care community to collaborate, including: debuting a new public awareness campaign to educate Americans about chronic kidney disease, reform the organ procurement and management system, examine ESRD payment policies, and expand evidence-based approaches to prevent kidney disease.

Building off of the tremendous progress we have made as a community over the last decade, we look forward to working with the White House, Department of Health and Human Services, and Congress to advance the laudable goals of the executive order. Kidney Care Partners (KCP) values its continued work with law- and policy-makers. Together, we brought the first value-based program, the ESRD Quality Incentive Program, to Medicare. We also established the Kidney Care Quality Alliance, which was the first measure development organization devoted to creating and maintaining facility-level quality measures for the Medicare ESRD program. The National Quality Forum has endorsed and CMS has adopted multiple measures developed by KCQA including those related to Medication Management and fluid removal during dialysis (ultrafiltration).

Today provides us with another exciting opportunity. Because public-private partnerships, such as KidneyX, have been crucial in accelerating innovative breakthroughs and setting the bar for kidney care higher, KCP applauds this new opportunity to work with stakeholders in and out of government to ensure that Chronic Kidney Disease (CKD) patients receive optimal care and are able to live quality lives.

We are pleased that the goals outlined by President Trump align well with our recently published Kidney Care FIRST (A Framework for Improving Renal Disease Support & Treatments). This visionary kidney care roadmap for the future, designed to improve patient outcomes and generate significant health care savings, addresses the critical areas to significantly improve the lives of individuals with chronic kidney disease, kidney failure, and kidney transplants. In tandem with the administration’s support and collaboration, KCP’s Kidney Care FIRST lays out in a great detail a framework to achieve improvements in kidney care nationwide by focusing on five major pillars: awareness and prevention; patient empowerment; quality and access to quality care; innovation; and, research. In addressing the entire continuum of chronic kidney disease, the community is prepared to use this framework as a foundation to improve access, care and choice.

Both the executive order and our community’s Kidney Care FIRST framework comes as Congress discusses new legislation that will also improve kidney care. The bipartisan Chronic Kidney Disease Improvement in Research and Treatment Act of 2019 (S.1676), recently introduced by Sens. Benjamin Cardin (D-Md.) and Roy Blunt (R-Mo.), will help millions of individuals living with chronic kidney disease and ESRD achieve the quality of life they want and deserve, if passed.

In sum, we are optimistic that increased focus on helping Americans with kidney disease will lead to meaningful outcomes for patients. This is the first time in my 40-year tenure serving this community that we are seeing such close coordination and alignment among the White House, HHS/CMS, Congress and the entire kidney care community.

Given rapid advancements in kidney care and the community-wide, public-private partnership collaborations necessary to achieve these ambitious goals, I believe the future is bright and hopeful for individuals living with kidney disease, kidney failure and transplants.

Dr. Allen R. Nissenson, MD, FACP, FASN, FNKY, is chair of Kidney Care Partners and Chief Medical Officer (CMO), DaVita Kidney Care. Kidney Care Partners (KCP) is a coalition of more than 30 organizations, comprised of patient advocates, dialysis professionals, care providers, researchers, and manufacturers, dedicated to working together to improve quality of care for individuals with Chronic Kidney Disease (CKD). For more information please visit

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