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NATIONAL KIDNEY MONTH
Mr. CARDIN. Mr. President, this March, as we mark National Kidney Month, we have the opportunity to remember those we have lost to kidney-related illnesses, recognize the work we have done to combat kidney diseases, and recommit to continue and expand on these efforts to improve the care available to those who are suffering.
Kidney disease is the tenth leading cause of death in the United States. Today, more than 37 million Americans have chronic kidney disease. One in three adults is at risk of developing chronic kidney disease, which can lead to kidney failure or end-stage renal disease, an irreversible condition that is fatal without a kidney transplant or dialysis. In Maryland alone, almost 93,000 Medicare patients have been diagnosed with chronic kidney disease, and almost 10,000 of these individuals are currently on dialysis.
As with many health issues, communities across the Nation do not suffer from kidney disease equally. Black Americans make up 35 percent of the people with kidney failure in the United States, despite only making up 13 percent of the U.S. population. Hispanic Americans are 1.3 times more likely to be diagnosed with kidney failure than non-
Hispanics. End-stage renal disease is 3.7 times more likely in Black Americans, 1.4 times more likely in Native Americans, and 1.5 more likely in Asian Americans than in White Americans. Patients of color also wait longer than White patients to receive a deceased donor transplant and are less likely to receive a living donor transplant.
While progress is often too slow, in the past year alone, we have made significant steps to understand and address factors leading to the overrepresentation of certain populations with chronic kidney disease. Following research from the National Kidney Foundation and the American Society of Nephrology, institutions like the University of Maryland Medicine ended the outdated use of race as a factor in diagnosing chronic kidney disease. This change will lead to earlier diagnosis and treatment of Black Americans.
Not surprisingly, the COVID-19 pandemic has had a devastating impact on those with severe chronic medical conditions like kidney disease. Patients with chronic kidney disease or end-stage renal disease are often immunocompromised, especially those on dialysis or taking immunosuppressive medicines as part of the process for a kidney transplant. Consequently, people with kidney disease are at a higher risk of developing a more severe case of, and dying from, COVID-19.
Last year, I reintroduced the Chronic Kidney Disease Improvement in Research and Treatment Act with Senator Blunt. This legislation takes important steps to expand kidney disease awareness and education, improve the accuracy and transparency of end-stage renal disease quality programs, incentivize innovation in dialysis care, and expand patient choices of insurance coverage.
Nearly one-half of the people suffering from chronic kidney disease do not know they have kidney disease because of inadequate screening programs and a lack of awareness about the disease. My legislation would expand Medicare's annual wellness benefit to include kidney disease screening for at-risk patients and improve access to pre-
dialysis kidney education programs to better manage patients' kidney disease--an effort that, in some cases, could actually prevent kidney failure and reduce the $153 billion Medicare spends on care for kidney patients.
To address health equity issues in chronic kidney disease, my legislation would also require the Department of Health and Human Services to submit a report to Congress on national kidney transplantation rates and make recommendations on prevention and treatment for communities disproportionally affected by kidney failure.
Further, my legislation would expand choices in health insurance coverage to those with end-stage renal disease by guaranteeing access to Medigap policies to all end-stage renal disease Medicare beneficiaries, regardless of age. Currently, Medicare patients under 65, whether disabled or end-stage renal disease beneficiaries, do not have access to Medigap plans, even though Medicare is their primary insurance.
The best treatment for kidney failure is kidney transplantation from a living donor, but only a third of kidney transplants are of this type. Over 100,000 Americans are on the transplant waitlist with 90,000 of them waiting for a kidney. Only 24,000 kidneys were transplanted in 2021. The average wait time for a deceased donor kidney transplant is 5 years but can be as long as 10 years in some States. But with the direct donation from a living donor, the average time is 3-6 months. Sadly, 114 patients in Maryland died while on the waitlist in 2021. This is why I am also a cosponsor of the Living Donor Protection Act, which works to remove barriers to organ donation and protect the rights of and prohibit discrimination against organ donors, with the goal of increasing the number of living donors.
Although the scientific understanding of kidney disease has progressed immensely, significant gaps persist, and treatment has remained largely the same. Research on kidney failure is underfunded compared with the costs of treating chronic kidney disease and end-
stage renal disease. I am proud of what the National Institutes of Health and other Maryland-based research institutions have done to combat kidney disease and other kidney-related illnesses. There is more to do, however, and I look forward to working with my colleagues to fight kidney diseases and bring relief to the millions of Americans who suffer from them.
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SOURCE: Congressional Record Vol. 168, No. 46
The Congressional Record is a unique source of public documentation. It started in 1873, documenting nearly all the major and minor policies being discussed and debated.
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