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Addressing Unmet Needs in the Management of Chronic Kidney Disease

Sylvia E Rosas1, Robert Busch2, Dominic S Raj3

  • 1Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.

International Journal of General Medicine
|July 17, 2026
PubMed

Insights

Chronic kidney disease (CKD) affects many US adults, often remaining undiagnosed due to barriers like social determinants of health. Improving screening and care requires addressing these issues and optimizing treatment for better patient outcomes.

Area of Science:

  • Nephrology
  • Public Health
  • Health Services Research

Background:

  • Chronic kidney disease (CKD) is a prevalent noncommunicable disease impacting over 1 in 7 US adults.
  • CKD significantly elevates the risk of cardiovascular disease (CVD), stroke, and mortality.
  • Hypertension and type 2 diabetes are primary drivers of CKD and kidney failure, necessitating early intervention.

Purpose of the Study:

  • To explore population-based unmet needs in CKD care.
  • To identify solutions for social determinants of health (SDoH) impacting CKD patients.
  • To discuss multidisciplinary care strategies and overcome clinical inertia for improved CKD screening and outcomes.

Main Methods:

  • This study is a narrative literature review based on the authors' experience and opinions.
  • The review synthesizes existing research on CKD prevalence, risk factors, and management challenges.
  • It focuses on identifying unmet needs and proposing actionable strategies for care improvement.

Main Results:

  • CKD is often asymptomatic in early stages, leading to delayed diagnosis and infrequent surveillance in high-risk populations.
  • Social determinants of health (SDoH), low awareness, communication gaps, and health literacy are significant barriers to effective CKD management.
  • Clinical inertia and suboptimal guideline-directed therapy contribute to poor patient outcomes.

Conclusions:

  • Addressing SDoH and enhancing patient-provider communication are crucial for equitable CKD care.
  • Multidisciplinary care approaches and overcoming clinical inertia can improve CKD screening rates and patient outcomes.
  • Optimizing guideline-directed therapy in primary and specialty care is essential for managing CKD effectively.

Keywords:
chronicdelivery of health carepatient carerenal insufficiencysocial determinants of health

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