Addressing unmet needs in the management of chronic kidney disease

Chronic kidney disease (CKD), prevalent in more than 1 in 7 US adults, is a major noncommunicable disease that increases the risk of cardiovascular disease (CVD), stroke, and mortality. Type 2 diabetes and hypertension are the most common causes of CKD and kidney failure. Early identification and management are critical because CKD is asymptomatic in early stages. However, annual surveillance of high-risk patients is infrequent, and many patients with moderate to severe CKD remain undiagnosed. Barriers to effective CKD care and management include social determinants of health (SDoH), low CKD awareness, communication between patients and health care professionals, health literacy, and the complexity of caring for patients with CKD. SDoH-related factors negatively affect access to health care, increasing the risk of developing CKD and leading to poor health outcomes resulting from delays in diagnosis and treatment. Based on the experience and opinions of the authors, this narrative review of the literature aimed to explore the population-based unmet needs of patients with CKD, address potential solutions to SDoH-related issues, discuss the importance of multidisciplinary care, and offer strategies to overcome clinical inertia to increase screening for CKD and improve patient outcomes. Opportunities for improving the management of patients with CKD in both primary and specialty care include avoiding clinical inertia and optimizing guideline-directed therapy.