NCQA Convenes Expert Panel on Chronic Kidney Disease

March 4, 2025 · Becky Kolinski

On January 28, NCQA convened a panel of experts—primary care clinicians, nephrologists, cardiologists, endocrinologists, pharmacists, patient representatives—to discuss ways to drive improvement in the quality of care for people with chronic kidney disease (CKD).

CKD affects 36 million adults in the U.S.—but 90% of people with CKD are unaware that they have it. CKD is under-prioritized in quality improvement efforts, which results in significant care gaps.​

“Chronic kidney disease is an important health issue that, if left untreated, can significantly impact a person’s quality of life,” says Caroline Blaum, NCQA’s Assistant Vice President, Chronic Conditions and Complex Care. “It is part of the cardiovascular-kidney-metabolic syndrome (CKM), which highlights the interconnected health risks of obesity, diabetes, cardiovascular disease and kidney disease.”

Impact of CKD on Population Health

CKD damages the kidneys and impairs their ability to filter blood. Common risk factors include diabetes, hypertension, heart disease, obesity, history of smoking, family history and age—nearly 40% of adults 65 and older have CKD, compared with 12% of adults 45–64.

There are five stages of kidney disease. Stage 5 is end-stage renal disease (ESRD), or kidney failure, which requires dialysis or a kidney transplant for continued survival. ESRD affects 808,000 adults in the U.S.; 69% of them are on dialysis. Early detection and management of CKD can delay its progression and reduce ESRD incidence.

Disparities persist in CKD diagnosis and treatment. It is more prevalent among non-Hispanic Black adults than non-Hispanic White adults, yet Black patients are less likely to be placed on transplant wait lists, and face longer wait times and lower survival rates post-transplant.

Goals of the CKD Panel

To guide a targeted discussion on preventive care and kidney health in the earlier stages of CKD, the panel focused on prevention and management, but did not address the complexities of managing ESRD.

NCQA defined three goals:

1. Inform a framework for expanding evaluation of quality of care, experience and outcomes related to CKD, while also considering how CKD contributes to cardiovascular-kidney-metabolic syndrome.​
2. Identify quality gaps in CKD screening and prevention, management and preventing or slowing progression.
3. Recommend solutions for closing quality gaps and improving CKD outcomes.

Discussion findings will contribute to NCQA’s larger effort to develop a quality framework aimed at improving awareness and care quality for CKM syndrome.

Key Recommendations

At the end of the meeting, NCQA asked participants to share one thing they would do to positively affect CKD prevention, diagnosis or treatment. Here’s what they said.

• Increase awareness among people living with CKD who may not know it.
• Involve more frontline staff—such as nurses and other direct care professionals—in conversations about driving improvement.
• Increase community and public engagement—from grassroots involvement in communities to broader education campaigns for the public.
• Hold routine testing for CKD—not just among at-risk populations, but for everyone.
• Encourage equitable implementation of proven therapies, specifically sodium-glucose cotransporter-2 inhibitors (SGLT2i).
• Improve access to and reimbursement for team-based care.
• Provide adequate resources for practices to assess patient’s social needs and help address them.

“The CKD discussion was energizing and inspiring,” says Blaum. “We learned a lot about the current state of the industry, in terms of screening, diagnosis and treatment, and that will help us define better measures of quality care for people with CKD.”

What’s Next

• NCQA will synthesize the discussion, findings and recommendations into a white paper planned for release this spring.
• We’ll distribute the paper through our blog, on our website and through other methods.

Acknowledgments

Thanks to our panel of experts for sharing their knowledge and insights. This research is made possible with support from Boehringer Ingelheim and Novo Nordisk.