New analysis from the National Kidney Foundation and Manatt Health also finds most Medicare enrollees still do not receive both tests needed to detect and assess chronic kidney disease
(NEW YORK CITY, NY - August 25, 2026) - Chronic kidney disease testing among Medicare enrollees improved modestly between 2016 and 2023, but those gains have not resulted in more patients being diagnosed in the earliest stages of the disease, according to a new nationwide analysis from the National Kidney Foundation (NKF) and Manatt Health.
The report, Trends in Chronic Kidney Disease Screening and Diagnosis Among Medicare Enrollees, examined nationwide Traditional Medicare and Medicare Advantage claims from 2016 through 2023.
During that period, the percentage of Traditional Medicare enrollees receiving both tests recommended to detect and assess chronic kidney disease (CKD) increased from 17% to 20%. Among Medicare Advantage enrollees, the rate increased from 24% to 28%.
Despite that progress, most Medicare enrollees still did not receive both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR) testing in 2023. The analysis also found no meaningful increase in the proportion of patients first diagnosed at CKD Stages G1 and G2, when treatment offers the greatest opportunity to slow progression and prevent serious complications.
“We have begun to close the kidney testing gap, but improvements in detection, awareness and treatment are the ultimate goals,” said Joseph Vassalotti, MD, Chief Medical Officer of the National Kidney Foundation. “In 2023, only one in five Traditional Medicare enrollees and fewer than three in ten Medicare Advantage enrollees received both tests—and patients were no more likely to be diagnosed in the earliest stages than they were several years earlier. Testing must not only lead to diagnosis, but also awareness and engagement to improve interventions.”
CKD affects more than one in seven U.S. adults, and about nine in ten people with the disease do not know they have it. Because CKD can progress without noticeable symptoms, routine use of both eGFR and uACR is essential to identify kidney dysfunction and damage, guide risk classification and create opportunities to slow progression and reduce cardiovascular and kidney failure risk.
A comprehensive kidney health evaluation uses both eGFR, a blood test that assesses kidney function, and uACR, a urine test that detects kidney damage. The analysis found that eGFR testing was common among Medicare enrollees, at approximately 80% or higher in most years, while uACR testing continued to lag significantly. Increases in uACR testing drove most of the improvement in comprehensive testing.
The analysis also found that Medicare Advantage enrollees consistently had higher rates of comprehensive testing than Traditional Medicare enrollees. The authors note that differences in care management, coding practices and financial or operational incentives may contribute to the disparity.
Although the proportion of patients diagnosed in Stages G1 and G2 remained largely unchanged, the analysis found improved precision in documenting the stage of disease. From 2017 to 2023, the percentage of newly diagnosed patients whose CKD stage was unspecified declined from 42% to 33% in Traditional Medicare and from 40% to 35% in Medicare Advantage. Accurate staging helps guide treatment decisions, referrals and appropriate follow-up care.
The findings reinforce the importance of NKF’s work to make comprehensive kidney testing a routine part of care for people at risk. Through its CKDintercept initiative, NKF developed and advanced the Kidney Health Evaluation quality measure, which assesses whether adults with diabetes receive both eGFR and uACR testing.
The measure has been adopted for the Centers for Medicare & Medicaid Services’ Merit-based Incentive Payment System and Medicare Advantage Star Ratings and by the National Committee for Quality Assurance for the Healthcare Effectiveness Data and Information Set (HEDIS). Because adoption of the measure is ongoing and the analysis extends only through 2023, its full effect may not yet be reflected in national diagnosis trends.
“This report gives us a national benchmark against which future progress can be measured,” Vassalotti said. “The goal is not simply to order more tests. It is to build a healthcare system that consistently identifies people at risk, recognizes kidney disease earlier and connects patients to care that can protect both their kidney and cardiovascular health.”
The report recommends continued monitoring and additional research into:
- Testing rates among people at high risk, including those with diabetes and hypertension
- The time between initial testing and a documented CKD diagnosis
- The effects of quality measures and payment incentives on testing and diagnosis
- Patient outcomes associated with earlier- versus later-stage diagnosis
The full report, Trends in Chronic Kidney Disease Screening and Diagnosis Among Medicare Enrollees, is available at: https://www.manatt.com/insights/white-papers/2026/trends-in-chronic-kid…
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 Manatt Health
Manatt Health integrates legal and consulting services to better meet the complex needs of clients across the health care system. Combining legal excellence, firsthand experience in shaping public policy, sophisticated strategy insight and deep analytic capabilities, we provide uniquely valuable professional services to the full range of health industry players. Our diverse team of more than 200 attorneys and consultants from Manatt, Phelps & Phillips, LLP, and its consulting subsidiary, Manatt Health Strategies, LLC, is passionate about helping our clients advance their business interests, fulfill their missions and lead health care into the future. For more information, visit https://www.manatt.com/Health.
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For Media Inquiries:
Paul McGee (716) 523-6874 or paul.mcgee@kidney.org