Chronic kidney disease (CKD) is increasingly recognized as a growing public health threat, with high global prevalence and poor health outcomes. In the United States, CKD affects more than one in seven American adults, an estimated 37 million people. The devastating health consequences of CKD, as well as the disease’s historically high prevalence in its early stages necessitate the development and implementation of public health strategies that facilitate prevention, earlier disease detection, and management to prevent complications and progression to kidney failure. 

The Milken Institute Center for Public Health brought together leaders from the public, private, nonprofit, health, and academic sectors to envision a pathway that addresses the public health and health-care system needs related to CKD. 

Through a landscape assessment and convenings with leaders, the Center for Public Health developed two companion deliverables titled Chronic Kidney Disease: Finding a Path to Prevention, Earlier Detection that explores opportunities to reshape the CKD ecosystem.   

• Report: Applying a public health approach, the report focuses on pressing issues pertinent to the CKD ecosystem and outlines tangible solutions to catalyze policy, system, and environmental change towards an integrated approach to CKD prevention and care.  

• Roadmap: The roadmap serves as a guide for implementing practical, evidence-based strategies that will advance engagement and progress in an equitable and sustainable manner. 

These deliverables detail strategies to drive four system-level changes and present stakeholder-specific actionable steps to transform the CKD ecosystem by capitalizing on eight identified opportunity areas. 

System-Level Drivers:  

1. Build a sustainable and diverse workforce for health communities 

2. Address public health and CKD research funding gaps  

3. Modernize public health data and surveillance  

4. Invest in upstream public health infrastructure  

CKD Opportunity Areas:  

1. Combat root causes of health inequity that contribute to CKD  

2. Optimize nutritional services to slow CKD progression  

3. Repurpose US primary care infrastructure to drive person-centered coordinated care 

4. Update CKD screening guidelines and promote universal adherence 

5. Invest in education and health communication platforms 

6. Leverage telehealth and innovative care models  

7. Establish and measure accountability in CKD care  

8. Incentivize high-quality care through value-based care models 

The report focuses on pressing issues pertinent to the CKD ecosystem and outlines tangible solutions to catalyze policy, system, and environmental change towards an integrated approach to CKD prevention and care.