{"id":26438,"date":"2023-10-13T09:42:21","date_gmt":"2023-10-13T13:42:21","guid":{"rendered":"https:\/\/avalere.com\/?p=26438"},"modified":"2024-01-16T19:11:37","modified_gmt":"2024-01-17T00:11:37","slug":"kidney-transplantation-current-barriers-and-evolving-policies","status":"publish","type":"post","link":"https:\/\/advisory.avalerehealth.com\/insights\/kidney-transplantation-current-barriers-and-evolving-policies","title":{"rendered":"Kidney Transplantation: Current Barriers and Evolving Policies"},"content":{"rendered":"
[vc_row][vc_column][vc_column_text]Note: This insight was originally posted on July 1, 2022. It was updated on October 13, 2023, to include new information.<\/em><\/p>\n

Chronic kidney disease (CKD) has been recognized as a rising public health concern, with\u00a037 million people<\/a> (approximately 15% of the adult population) in the US estimated to have some form of kidney function impairment. Patients with CKD often have multiple comorbidities such as diabetes, hypertension, and heart disease, which can both cause and co-exist with kidney disease. Furthermore, approximately 90% of people living with kidney disease do not know that they have it. CKD may progress to kidney failure, otherwise known as end-stage renal disease (ESRD), which requires renal replacement therapy (either via dialysis or kidney transplantation). The cost to treat a patient varies by treatment type; according to the US Renal Data System<\/a>, Medicare pays $93,000 annually to cover hemodialysis for an ESRD patient versus $37,000 for a patient each year beyond the first year of receiving a kidney transplant.<\/p>\n

Barriers to Kidney Transplantation<\/h2>\n

Kidney transplantation<\/a>, from both deceased and living donors, is associated with improved survival, reduced expenses, and enhanced quality of life for patients with ESRD. However, despite increasing clinical and economic benefits of kidney transplantation, dialysis remains the most utilized treatment for patients living with ESRD in the US. A survey<\/a> of transplant center staff identified the following barriers to patients receiving kidney transplants: limited organ availability, low health literacy, lack of understanding of the transplant process, and challenges driven by social determinants of health. Many patients are unaware that transplantation is a treatment option, and patients who do not have access to a living donor are put on the national transplant waiting list to be matched with a kidney from a deceased donor. As of 2022,\u00a0more than 92,000 patients\u00a0<\/a>are waiting for a kidney. The average time spent waiting for a kidney transplantation is 3\u20135 years, and the 5-year survival rate on maintenance dialysis is 50%.<\/p>\n

Policies to Improve Kidney Care and Increase Transplantation Rates<\/h2>\n

Both the Trump and Biden administrations have introduced policies and initiatives to support access to transplantations. The Advancing American Kidney Health<\/a> initiative, launched by the Department of Health and Human Services in 2019, was the initial driver of change in the broader kidney care space, creating new policies and payment models to reduce risk of kidney failure and improve access to and quality of treatment options. Specific details of these policies and additional activities are outlined below.[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_single_image image=”30434″ css=”.vc_custom_1697204507249{margin-top: 30px !important;margin-bottom: 20px !important;}” img_caption=”Figure 1. Recent Policy Developments in Kidney Transplantation”][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n