[Congressional Record Volume 168, Number 46 (Tuesday, March 15, 2022)]
[Senate]
[Pages S1175-S1176]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         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

[[Page S1176]]

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Medicine ended the outdated use of race as a factor in diagnosing 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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