Op-Ed: Protecting Quality Care for Dialysis Patients

As a nephrologist, it is my mission to promote equal healthcare access and to end racial disparities in the care of patients with kidney disease. More than 37 million Americans have chronic kidney disease (CKD), and Black people are disproportionately affected, being 4.2 times more likely to develop kidney failure compared with white people. Once someone progresses to End Stage Renal Disease (ESRD), their only treatment options are dialysis or a kidney transplant. Dialysis patients, who must have their blood filtered through a machine multiple times a week, often struggle with elevated phosphorus levels, which can lead to serious complications such as bone fractures, heart disease, strokes, and even death if not properly managed. Fortunately, there are effective prescription Phosphate Lowering Therapies (PLTs) available, including phosphate binder pills and a new phosphate blocker that received FDA approval in October 2023. However, access to these therapies may soon be in jeopardy. As the General Accounting Office (GAO) highlighted in its November 2023 report, the inclusion of oral PLTs in the bundle may require dialysis organizations to expand their capacity to dispense high volumes of these drugs. The GAO wrote that “All dialysis organization representatives GAO interviewed anticipate needing to expand their...