The National Kidney Foundation’s Chief Medical Officer, Dr. Joseph Vassalotti, shares strategies for kidney care.
Americans spent $3.6 trillion dollars on healthcare in 2018. Medical spending as a percentage of US GDP was near 18% in that same year.
And within that larger healthcare picture, kidney disease looms large, with incomplete diagnosis, insufficient risk stratification, ineffective treatment implementation, poor health outcomes, and a high price tag for patients, employers, and taxpayers. To put that in perspective, in 2018, Medicare costs associated with patients with any stage of kidney disease were $130 billion.
Correspondingly, it’s clear that health care, and kidney care, in particular, would greatly benefit from disruptive, non-traditional thinking and new solutions in diagnostics, prognostics, and care models.
Recently, Elise Wilfinger from Renalytix discussed “disruption in kidney care” with Joseph Vassalotti, MD, FASN, and the National Kidney Foundation’s Chief Medical Officer since January 2006. Dr. Vassalotti also holds a Clinical Professor of Medicine position in the Division of Nephrology at Mount Sinai Medical Center in New York City.
To begin, Dr. Vassalotti assessed the current state of kidney disease, stressing the need for improved care of Americans living with kidney diseases.
As the population grows and ages, obesity increases and so too does the prevalence of diabetes and hypertension, which, in turn, drives a higher prevalence of kidney disease. Today’s sedentary lifestyle coupled with diets that are filled with more processed foods fuel the situation.
So what challenges do we need to understand to help us overcome this obstacle? Dr. Vassalotti specifies six different challenges:
People don’t experience symptoms
Testing is inadequate
Risk control is limited
Diverse populations suffer at a greater rate
And the divide has widened with COVID-19
Overall, chronic kidney disease care has also taken a hit with the pandemic
To disrupt kidney care with difference-making strategies, Dr. Vassalotti recommends placing focus in the following areas:
Shift the paradigm from excellent sick care to excellent well care
Leverage patient fear as motivation for action
Integrate upstream kidney care into primary care
Implement more broad-scale use of clinically proven medications
Reinvigorate the momentum of 2019.
To improve the diagnosis and treatment of kidney health, Dr. Vassalotti shares some of the steps the National Kidney Foundation is taking to improve these things,
Clinical practice guidelines recommend that people with diabetes be routinely tested to detect kidney disease. While the tests associated with kidney disease detection and diagnosis are inexpensive and widely available for routine clinic visits, less than 50% of people with diabetes receive both tests annually in the U.S.
The new Kidney Health Evaluation HEDIS Measure will reveal these gaps in care for clinicians, healthcare leadership, and health plan executives. Moreover, the availability of both these tests will more precisely risk-stratify patients for kidney protective therapies and provide the raw data necessary for kidney population health management.