US kidney care gaps raise global concern

Washington, March 20 (IANS) As the United States struggles with rising kidney disease cases and high treatment costs, lawmakers warned that gaps in prevention and innovation could have wider implications for the global health system.

Lawmakers and medical experts, during a Congressional hearing on Thursday, painted a stark picture of a system under strain, where late diagnosis, limited innovation, and uneven access to care continue to drive poor outcomes.

“15 per cent of American adults live with some form of CKD and more than 800,000 patients live with ESRD,” said Chairman Vern Buchanan, adding that “more than 500,000 of them” require hours of dialysis each week.

He underscored the severity of the condition, noting that “almost 60 percent of patients die within five years of starting dialysis.”

The financial burden is equally severe. Although kidney disease accounts for only a small share of patients, it disproportionately drives Medicare spending. Buchanan said these patients make up “only 1 percent of the Medicare population” but account for a significant portion of costs.

Experts said the crisis is being driven by failures in early detection. Dr Suzanne Watnick told lawmakers that “nine of ten Americans living with kidney disease… don’t know that they have it,” highlighting the silent progression of the illness.

She warned that outcomes remain grim due to underinvestment. “More than half of people who start dialysis today will not be alive in five years,” she said, adding that innovation in kidney care has lagged behind other fields.

Patient testimony heightened the urgency of the discussion. Ashli Littleton, who has lived with kidney failure for years, said, “Dialysis is the reason I am alive.”

She described the lack of early awareness and guidance. “Too many patients are making life altering decisions without fully understanding their options,” she said, calling for better education and support.

Littleton said shifting to home treatment improved her quality of life. “Home dialysis allowed me to live my life with dignity, independence, and flexibility,” she said.

Lawmakers from both parties stressed the need to expand home-based care. Congressman Jason Smith said only “15 per cent of all ESRD patients in this country receive treatment at home,” calling it a missed opportunity to improve outcomes.

Doctors pointed to a lack of awareness as a key barrier. Dr Robert Taylor said many patients are not informed about alternatives. “She did not even know that home dialysis was a therapy,” he said, referring to Littleton’s experience.

Beyond access, policy hurdles were flagged as a major concern. Industry leaders argued that existing payment systems discourage innovation.

“Medicare policies are driving away investment where it’s needed the most,” said John Butler, adding that the current system “discourages the uptake of new technology.”

He warned that “there is almost no investment in innovation for dialysis patients today,” despite high mortality rates.

Lawmakers also raised concerns about healthcare coverage and research funding. Congressman Lloyd Doggett said cuts to Medicaid and medical research “jeopardized the health of those patients” and could result in “fewer innovative treatments.”

There was broad agreement that prevention must be the priority. Dr Watnick said, “We need to start upstream. We want people never to walk through those dialysis treatment doors.”

Experts pointed to diabetes and high blood pressure as the main drivers of kidney disease, stressing the need for early screening, lifestyle changes and sustained care.

Kidney disease affects more than 37 million people in the United States and is among the costliest chronic conditions treated under Medicare.

--IANS

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