Chronic Kidney Disease — A Quiet Revolution in Nephrology

Six Case Studies

Richard A. Rettig, Roberto B. Vargas, Keith C. Norris, Allen R. Nissenson

ResearchPublished Jun 25, 2010

Examines changes in nephrology as it evolves from a focus on end-stage renal disease (ESRD) to the treatment of earlier stages of chronic kidney disease (CKD). Once patients reach ESRD, treatments are limited to kidney transplantation and dialysis. However, the progression of earlier stages of CKD can be slowed, halted, or reversed when treated. Data from 15 clinics focusing on CKD are examined, with the focus on six case studies. Clinics are still establishing best-practice models, and reimbursement remains a challenge. Recommendations also include widespread education for primary care physicians on how to interpret levels of kidney function and on referral of patients with decreased kidney function to nephrologists before ESRD is reached.

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Rettig, Richard A., Roberto B. Vargas, Keith C. Norris, and Allen R. Nissenson, Chronic Kidney Disease — A Quiet Revolution in Nephrology: Six Case Studies. Santa Monica, CA: RAND Corporation, 2010. https://www.rand.org/pubs/technical_reports/TR826.html.
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This work was sponsored by the National Institutes of Health's National Center for Research Resources, which funded the Comprehensive Center for Health Disparities at Charles Drew University. The research was conducted in RAND Health, a division of the RAND Corporation.

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