Chronic Kidney Disease Change Package Aims to Improve Diagnosis

National Kidney Foundation launches new tools for clinicians and public health practitioners to improve screening, recognition and management of the disease
New York, NY—January 9, 2019—Chronic Kidney Disease (CKD) is a largely invisible and growing public health problem that is widely under-recognized; and it is rising faster than all noninfectious diseases, including cardiovascular disease. Despite current guidelines which recommend CKD testing for adults with diabetes and/or hypertension yearly, less than 10% of those with hypertension and less than 40% of those with diabetes are completely assessed. To better address the problem and improve recognition of CKD, the National Kidney Foundation has released a comprehensive “Chronic Kidney Disease Change Package: Population Health Strategies for Cardiovascular and Kidney Disease Risk Reductionreport for clinicians and public health practitioners which includes a list of suggested improvements to increase CKD screening, recognition and management.   The CKD Change Package website is:
 “Early identification and treament of CKD can reduce the risks of heart attack, stroke, and delay progression to kidney failure,” said Joseph Vassalotti, MD, Chief Medical Officer, National Kidney Foundation.  “NKF’s new CKD Change Package aims to help busy primary care physicians integrate CKD testing and care into diabetes and hypertension management.”
Diabetes and hypertension are key risk factors for cardiovascular disease and kidney disease. Two simple tests, an eGFR (which assesses kidney function) and an ACR (which assesses kidney damage) conducted in patients with diabetes or hypertension are strong predictors of cardiovascular risk.
The CKD Change Package follows the format of the Million Hearts Hypertension Change Package in compiling change concepts, change ideas, evidence or practice-based tools and resources, and includes data and ideas collected through interviews with clinical teams that have integrated CKD into primary care settings. The CKD Change Package contains suggestions for how to assess the effectiveness of CKD care, provides suggestions for how to create a committee to design a CKD intervention within each clinical practice, recommends targets for quality improvement teams, and provides tools and resources for clinicians to improve how they engage and educate people with CKD.  The concepts and ideas outlined in the CKD Change Package are process improvements that can be customized to practice size and to resources available; and tested to rapidly evaluate how they impact patient outcomes.
“Patients with CKD are at an increased risk of developing cardiovascular disease, but nearly 80% of those patients are unaware that their condition puts them at greater risk for experiencing heart attacks or stroke,” said Janet Wright, MD, Executive Director of the Million Hearts program. “Approximately half of all CKD patients die from cardiovascular events without ever progressing to kidney failure. Educating clinicians and public health practitioners on how to improve diagnosis and management of the disease is critical to this patient population.”
Diabetes accounts for 44% of all end stage renal disease cases,“ said Ann Albright, PhD, RD, Director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC). “Understanding the correlation of diabetes to cardiovascular disease and chronic kidney disease is essential for patients and primary care physicians are the first line of defense in ensuring that patients are receiving the education and treatment they need.”
In addition to the health toll CKD takes on patients over time, the medical costs of treating patients with CKD dramatically increase with each progressive stage of the disease. For patients in stage 2, the average costs to treat CKD annually are $16,770; costs for stage 3 are $33,200; and for patients in stage 4-5 (end-stage renal disease), the costs are $76,969. Early diagnosis is key to giving patients the best chance for a positive outcome and reducing long-term medical costs.
The CKD Change Package document will be updated and modified as new institutions make NKF aware of their CKD programs.  Any care team focused on CKD population health is invited to share their program and best practices at
Kidney Disease Facts
In the United States 30 million adults are estimated to have chronic kidney disease—and most aren’t aware of it.  1 in 3 American adults are at risk for chronic kidney disease.  Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history.  People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease.  African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end stage renal disease (kidney failure).
The National Kidney Foundation (NKF) is the largest, most comprehensive and longstanding organization dedicated to the awareness, prevention and treatment of kidney disease. For more information about NKF visit   
[1]Golestaneh L, Alvarez PJ, Reaven NL, et al. All-cause costs increase exponentially with increased chronic kidney disease stage. Am J Manag Care. June 2017;23(suppl 10):S163-S172