Time to tackle kidney disease head-on

Approximately 50 years ago, kidney failure was virtually a death sentence.

Fortunately, in 1972, Congress had the foresight and compassion to create the Medicare end-stage renal disease (ESRD) benefit. In doing so, Congress ensured that regardless of age or income, any American would have access to life-saving dialysis care. That, along with kidney transplant advances and technology, was the turning point in kidney care, giving patients hope and life.


Today in the U.S., more than 636,000 Americans suffer from ESRD, and 430,000 are on dialysis, a number that is expected to double over the next decade. Nearly 100,000 of these individuals are on a kidney transplant waiting list, which takes years on average for those who are even able to obtain one. 

And while we’ve made measurable improvements in both kidney care and disease awareness, the toll of kidney disease is vast and constantly growing. It is also expensive, costing patients and taxpayers billions of dollars each year and — even more significant — impacting millions of lives. For that reason, we have now introduced legislation that can make a difference in the lives of millions and impact many, many more.

The Chronic Kidney Disease Improvement in Research and Treatment Act, H.R. 1130, would empower physicians and nephrologists to build upon the quality improvements in kidney care both now and in the future — all while crafting a more cost-effective health delivery system. 

First, the bill would make kidney care more efficient by focusing on existing resources together with common-sense Medicare policy changes, emphasizing coordinated care and allowing kidney patients greater choice and access. 

Coordinated care is an effective approach to medicine that facilitates communication among specialists treating the same patient, often across numerous care settings. Expanding such a system would prove vital for individuals with kidney disease, especially for those living with several co-morbidities, such as diabetes and hypertension, which complicate care and impact health outcomes. H.R. 1130 would incentivize nephrologists and dialysis providers to further develop innovative coordinated care organizations that better serve patients.

In addition, to ensure the benefits of coordinated care, we must allow Americans with ESRD access to Medicare Advantage plans. Currently, dialysis patients on Medicare are not given the choice of enrolling in Advantage plans, which can provide broader coverage at lower patient cost. The bill would eliminate the antiquated — and truly senseless — restriction.

The legislation also would bolster biomedical research and fortify efforts to better treat, avoid and possibly even cure kidney disease and ESRD. The bill advances these goals by requiring an assessment of federal funding for chronic kidney disease research and identifying gaps in current research efforts. The bill also requires a strategic plan to better coordinate research efforts among multiple federal agencies. Finally, the legislation establishes an in-depth research study to better understand the disproportionate effect of kidney disease on minority populations. 

Through these three measures, kidney research would be set on a path to truly make a difference without levying an undue burden on taxpayers.

The bill also opens up additional pathways to enhanced kidney care. For instance, it explores largely untapped options for underserved dialysis patients by increasing access to health professionals through telemedicine and also facilitates greater economic stability among providers treating patients with chronic kidney disease, securing future investment and making innovations in kidney care. 

Ultimately, as far as investments go, there is nothing smarter than supporting better health. Each provision in H.R. 1130 bolsters efficiency and access to care, which will reduce both federal and individual spending on kidney care. Most importantly, though, the legislation delivers hope to millions of Americans suffering from kidney disease and many more to come. 

Marino has represented Pennsylvania’s 10th Congressional District since 2011. He sits on the Foreign Affairs, the Homeland Security, and the Judiciary committees.