Kidney disease and the employer's chronic care playbook

An estimated 11 million U.S. workers are living with CKD.

Those with later stages of the disease represent just 1% of the workforce but account for roughly 8% of employer health care costs, according to a recent report from the American Kidney Fund and the National Alliance of Healthcare Purchaser Coalitions.

The good news?

Most employers don't need to build new programs to address this challenge.

Many already have the right tools in place.

They just need to intentionally include kidney disease prevention and management in their existing programs.

Quiet risk

Diabetes is the leading cause of CKD, with high blood pressure a major contributing factor, and kidney disease typically develops slowly and quietly.

Most people with early-stage disease have no symptoms.

Standard lab tests can detect kidney damage before symptoms appear, but those tests aren't always part of routine preventive care, or they aren't highlighted even when results are available.

As a result, a kidney disease diagnosis often surfaces late, when employees need dialysis or a transplant.

Dialysis alone can exceed $90,000 per patient annually, and doesn't account for lost productivity, disability claims or turnover when employees can no longer work.

This pattern creates volatility for employers.

Late-stage kidney disease often shows up as a sudden spike in catastrophic claims rather than a manageable trend.

Screening

Employers already pay for many of the tests that detect kidney disease early.

Blood and urine tests measuring kidney function are inexpensive and widely available.

The challenge isn't access; it's consistent use for the highest-risk employees.

Workers with diabetes, high blood pressure, cardiovascular disease or a family history of kidney disease should be screened regularly.

For employers, this means working with health plans and care partners to confirm that kidney testing is built into preventive care protocols and chronic condition pathways.

This doesn't require a new benefit category; it only requires alignment.

When kidney tests become routine rather than optional, employers can catch problems earlier, yielding far better health outcomes at a significantly lower cost for care.

Awareness

Even when screening is available, employees may not understand why it matters.

Many don't know that diabetes is the leading cause of kidney failure, or that high blood pressure is a major contributing factor, or that kidney damage can progress silently for years.

Employer education efforts already address nutrition, medication adherence and lifestyle changes for diabetes and heart disease.

Kidney health fits naturally into those same messages.

Simple information about kidney function, what lab results mean and how managing blood sugar and blood pressure protects the kidneys can make a crucial difference.

When employees understand the connection, they're more likely to follow care plans and seek help earlier.

Education also helps reduce fear.

A kidney disease diagnosis doesn't automatically mean dialysis.

Early diagnosis and treatment can slow progression and help people stay healthy and working for years.

Chronic care strategy integration

Kidney disease shouldn't be treated as a standalone condition.

It belongs in an employer's broader chronic care strategy.

Many employers already contract with third-party vendors to help their employees manage diabetes, hypertension, or cardiovascular risk.

Kidney disease should be part of those programs, with shared data, coordinated outreach and aligned care goals.

Diabetes management programs, for example, can track kidney health metrics alongside A1C levels.

Care teams can flag declining kidney function and adjust treatment plans before complications arise.

This kind of integration reduces duplication, improves care coordination and helps employers get more value from programs they're already paying for.

A way forward

Employers don't need to wait for kidney disease to show up in catastrophic claims data before taking action.

Screening, education and integration are practical steps that fit into existing benefit programs.

The real question isn't whether employers can afford to pay attention to kidney disease; it's whether they can afford not to.

Late-stage kidney failure is one of the most expensive health outcomes an employer can face, yet much of that cost is preventable.

By treating kidney disease with the same rigor they bring to diabetes and other chronic conditions, employers can reduce surprise costs, support employee health and create more sustainable health plans over time.

Early kidney care isn't just good medicine.

It's a smart benefits strategy.

LaVarne Burton is the president and CEO of the American Kidney Fund. She previously was president of the Pharmaceutical Care Management Association.