(New York City, NY – August 22, 2025) – The National Kidney Foundation (NKF) Population Health team published “Closing Gaps in Chronic Kidney Disease Detection: Evaluating At-Home Targeted Testing in a Safety-Net Population” in the Journal of Primary Care & Community Health online ahead of print. The paper reviews healthcare quality improvements achieved through an at-home kidney testing program orchestrated by the NKF with Affinia Healthcare, a Federally Qualified Health Center in St. Louis, Missouri. The program resulted in the complete testing of 1,496 people at risk for chronic kidney disease (CKD) of whom 50% had evidence of increased urine albumin-creatinine ratio (uACR) or albuminuria.
Safety-net healthcare settings, such as Affinia Healthcare, bear a disproportionate burden of CKD with higher numbers of patients with risk factors, social deprivation, and barriers to diagnostic testing which delay timely access to diagnosis and treatment. Despite longstanding recommendations from the Kidney Disease International Guideline Organization, NKF, and American Diabetes Association, uACR testing rates remain low, with most people at risk for CKD, those living with diabetes (<50%) and hypertension (<15%), receiving the recommended uACR test each year.
“The uACR test is a marker for kidney and small blood vessel damage, accelerating progression of CKD into kidney failure and elevated risk for coronary artery disease, stroke, heart failure, arrhythmias, and microvascular disease,” said Joseph Vassalotti, NKF Chief Medical Officer. “Since uACR findings may be the earliest indicator of CKD, early detection of albuminuria provides the opportunity for evidence-based lifestyle interventions and medications that slow kidney disease progression and reduce cardiovascular risk.”
Affinia Healthcare employed NKF’s CKD Data Strategy within its electronic health record (EHR) to identify 4,677 high risk patients eligible to receive an at-home uACR testing kit. Of the 755 patients with evidence of albumin in the urine, 69% of results appeared in patients under 60 years old. Consistent with national data, Affinia patients identifying as Black were significantly more likely to have albuminuria. The testing results were automatically routed to the EHR, enabling providers to quickly coordinate necessary follow-up care. Subsequently, 84% of patients had follow-up visits and 32% completed appropriate follow-up testing based on clinical guidelines.
“This partnership has allowed us to provide patient care and support in a way that encourages our clinicians and patients to collaborate for better health outcomes,” said Takisha Lovelace, COO, Affinia Healthcare. “Part of our mission is to eliminate barriers to better health, and this program has provided another way to help us accomplish this with our patients.”
“The Affinia program illustrated that albuminuria was prevalent across all age groups. However, 69% of abnormal results occurred in patients under 60 years, a population typically with the lowest rates of uACR testing,” Elizabeth Montgomery, National Vice President, Clinical Innovation and Population Health added. “Findings from this collaboration highlight the urgency in improving uACR testing for early CKD diagnosis and demonstrate the value of at-home testing for healthcare quality improvement in underserved communities.”
The home testing employed in this NKF demonstration project was provided by Healthy.io, involving a urine sample and a smartphone to complete the test. “We are encouraged to see the adoption of our technology to help play a meaningful role in increasing access to help address the CKD health equity crisis in the US market”, said Geoff Martin, CEO of Healthy.io.
The full article can be found here: https://doi.org/10.1177/21501319251358923
To learn more about CKDintercept and strategies for healthcare quality improvement, please visit https://www.kidney.org/professionals/ckdintercept or contact population.health@kidney.org.
About Kidney Disease
In the United States, CKD remains an under-recognized public health burden that impacts 1 in 7 adults, and 90 percent of those affected are unaware of their condition. Approximately 1 in 3 U.S. adults are at risk for CKD, but less than 20% are assessed with guideline-recommended testing, eGFR and uACR. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity, and family history. People of Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian American, or Native Hawaiian or Other Pacific Islander descent are at increased risk for developing the disease. Black or African American people are about four times as likely as White people to develop kidney failure. Hispanic and Native American people experience kidney failure at approximately double the rate of White people.
About the National Kidney Foundation
The National Kidney Foundation is revolutionizing the fight to save lives by eliminating preventable kidney disease, accelerating innovation for the dignity of the patient experience, and dismantling structural inequities in kidney care, dialysis, and transplantation. For more information about NKF, visit www.kidney.org.
About Affinia Healthcare
Affinia Healthcare is an award-winning, nationally accredited community health center, providing affordable primary and preventive health care for St. Louis, Missouri, area residents. Affinia Healthcare, a 501(c)(3) non-profit organization, is accredited through The Joint Commission and National Committee of Quality Assurance organizations. Established in 1906 as the Holy Cross Dispensary, Affinia Healthcare today serves over 43,700 people per year, of whom more than 90 percent have incomes under 100 percent of the federal poverty level. Approximately 70 percent of patients served are Black or African American, 11 percent are Hispanic/Latinx, and over 4,000 are un-housed. For more information about Affinia Healthcare, visit www.affiniahealthcare.org.
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Contact:
Sam Tyler 212.889.2210 x 141
Email: sam.tyler@kidney.org