Early detection and treatment are critical to managing any chronic disease and it is especially vital to preventing chronic kidney disease (CKD) from progressing to end-stage renal disease. Early screening is important with this condition because many people with CKD may not have any severe symptoms until their kidney disease is advanced. If CKD goes untreated, kidneys can stop working and kidney failure is imminent. Kidney failure is also known as end-stage renal disease (ESRD) which requires dialysis or a kidney transplant to survive.  Diabetes is the most common cause of kidney failure.¹

2018-2023

The overarching goal of NJDOH’s Chronic Renal Disease Program is to assist in the development of statewide programs for the care and treatment of persons suffering from chronic renal diseases, including medical procedures and techniques which will have a lifesaving effect in the care and treatment of persons suffering from the diseases. Funds are awarded to provide care for eligible patients with End Stage Renal Disease (ESRD) on renal dialysis through medication and nutritional supplement assistance. The grantee plans and conducts annual organized outreach efforts to licensed dialysis centers, with special emphasis on assuring medication and nutritional supplements assistance for the uninsured, minority, and/or low-income populations as defined in the eligibility criteria as well as reaching disadvantaged racial and ethnic minority groups. Our main objectives are to:

• Provide New Jersey residents with End Stage Renal Disease (ESRD) primary and tertiary services 
• Increase accessibility to renal medications and nutritional supplements 
• Reduce the incidence of ESRD
• Reduce death due to ESRD

To persons who meet the following eligibility criteria:

• No health insurance coverage or limited health insurance coverage
• Income at or below the most recent Federal Poverty Level Guideline

Projects

• The NJDOH End Stage Renal Disease (ESRD) Patient Assistance Program provides financial reimbursement for formulary-based medications and nutritional supplements for people with ESRD receiving renal dialysis at a facility enrolled in the Renal Disease Patient Assistance Program who have an income at or below 300% of the federal poverty guideline.
• The five-year (2023-2028) CDC cooperative agreement A Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes will support grantees to improve early detection of chronic kidney disease (CKD) in priority populations with diabetes.

Proposed Legislation

• S1028/A2020 establishes the Kidney Disease Prevention and Education Task Force

Grants and funding given by NJDOH

• NJDOH partnered with the National Kidney Foundation to assess current testing rates and increase testing for Chronic Kidney Disease for people diagnosed with diabetes.  
• In 2021, NJDOH funded the Transatlantic Renal Council (TARC), Inc to provide renal medication and/or nutritional supplements to 50 facilities in New Jersey.  In fiscal year 2021, over 512 patients were served. 

Grants received by NJDOH

• CDC Cooperative Agreement DP23-0020:  Strategic Approach to Advancing Health Equity for Priority Populations with or at Risk for Diabetes (2023-2028)
• CDC Preventive Health and Health Services Block Grant

Assets/resources

• The National Kidney Foundation offers education and support to individuals and professionals. 
• The state-funded Kidney Renal Program provides kidney dialysis to individuals with no insurance or Medicaid.

Challenges

• An estimated 37 million Americans have chronic kidney disease (CKD). Nearly 90% do not know about their condition because of low awareness about the importance of CKD testing and diagnosis among practitioners and people at risk for CKD.²
• The number of individuals needing free dialysis services is increasing, therefore more funding is needed.

Disparities/inequities

• Chronic kidney disease is disproportionately distributed across the population. There are significant disparities in prevalence, treatment, and mortality based on race/ethnicity, socioeconomic status, and weight status.
• For all four Healthy New Jersey 2020 objectives, the rate among Black persons was more than double that of other racial/ethnic groups throughout the decade.

Final Assessment

• Deaths due to kidney disease and ESRD disease due to diabetes met their respective targets.
• There was little or no change in the ESRD incidence rate.
• The ESRD death rate increased, rather than decreasing.

For more information, please refer to these resources:

• NJDOH End Stage Renal Disease (ESRD) Patient Assistance Program
• CDC Chronic Kidney Disease Initiative
• National Institute of Diabetes and Digestive and Kidney Diseases
• American Association of Kidney Patients
• National Kidney Foundation
• Healthy People 2030

References: 

1. Chronic Kidney Disease. Healthy People 2020. 10/8/20.
2. Alfego D, Ennis J, Gillespie B, Lewis MJ, Montgomery E, Ferrè S, Vassalotti JA, Letovsky S. Chronic Kidney Disease Testing Among At-Risk Adults in the U.S. Remains Low: Real-World Evidence From a National Laboratory Database. Diabetes Care. 2021 Sep;44(9):2025-2032.