Kidney Week 2025 Annual Meeting-Bridging Gaps in CKD Care: Advancing Health Equity Through Policy, Practice, and Community Action

Video Transcription

Video Summary

The session “Bridging the Gaps in Chronic Kidney Disease Care” focused on advancing kidney health equity through policy, practice change, and community action. Dr. Cynthia Delgado reviewed the history of U.S. dialysis policy, highlighting how the 1973 Medicare ESRD program dramatically expanded access but primarily addresses end-stage disease. She argued for shifting upstream—using today’s therapies, risk stratification tools, and early-stage CKD management to prevent progression, reduce deaths, and lower costs. While newer drugs (SGLT2 inhibitors, GLP-1 agents, nonsteroidal MRAs) improve outcomes, uptake remains low, and dialysis remains far more expensive than pre-dialysis care. She called for expanded federal policy and advocacy to create a broader “kidney disease program,” not just ESRD coverage.<br /><br />Dr. Elizabeth Montgomery (NKF) described national implementation of the 2021 CKD-EPI race-free eGFR equation. Rapid lab adoption occurred via coordinated toolkits and partnerships, but gaps persist—especially in “desktop” analyzers within hospitals that may still use race-based equations. She cited major transplant equity impacts: thousands of Black patients had wait times adjusted, shortening time by an average of 1.7 years, with over 6,000 transplants attributed to the change. NKF is also pushing pharmacy alignment, recommending CKD-EPI over Cockcroft-Gault for drug dosing, and scaling primary care interventions to improve CKD detection and UACR testing.<br /><br />Dr. Tintin Dave presented evidence of global and U.S. inequities in SGLT2 inhibitor and GLP-1 use. Despite strong trial evidence, adoption is low and uneven across countries, regions, and racial/ethnic groups, driven by structural barriers, system factors, and adherence drop-offs.<br /><br />Dr. Rebecca Allen discussed measuring CKD education impact and showed how AI/NLP can analyze patient-language data to assess needs and outcomes, emphasizing careful, privacy-safe implementation.

Asset Subtitle

Moderator(s): Clare Lyas, Jan Williams

Presentation(s):

National Policy for Kidney Health Equity: The Time Is Now - Cynthia Delgado
Mitigating Disparities with Race-Free Clinical Formulas and Nomograms - Elizabeth Montgomery
Global Inequities in SGLT2 and GLP-1 Use Among Patients with CKD - Chintan Dave
Impact of Investment in CKD Education: Does It Pay Off? - Rebecca Allen

Meta Tag

Date 11/6/2025

Pathway 1 CKD Non-Dialysis

Session ID 507338

Keywords

chronic kidney disease care

kidney health equity

Medicare ESRD program 1973

upstream CKD prevention

early-stage CKD management

CKD risk stratification tools

SGLT2 inhibitors uptake

GLP-1 receptor agonists

nonsteroidal mineralocorticoid receptor antagonists

dialysis policy reform

kidney disease program expansion

2021 CKD-EPI race-free eGFR equation

race-based eGFR removal

transplant waitlist equity

AI NLP for CKD patient education evaluation