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The CARE for All Kidneys Act aims to assist people on dialysis in rural areas

The Coordination, Accountability, Research, and Equity (CARE) for All Kidneys Act of 2021 includes numerous provisions to help address the high rates of kidney failure in rural areas.

People living in rural areas have high rates of kidney failure, and the Coordination, Accountability, Research, and Equity (CARE) for All Kidneys Act of 2021 has been introduced to address this issue.

Kidney failure is when the kidneys no longer function, and you need to go on dialysis or receive a kidney transplant to survive. Dialysis is a treatment to clean the blood when kidneys are not able to. It helps the body remove waste and extra fluids in your blood.

Kidney failure is growing at a concerning rate in rural areas. Nineteen percent of people in the U.S. live in a rural area but they make up 22% of people on dialysis. According to a study published in Kidney International in 2012, people on dialysis who live more than 100 miles away from a dialysis center have a higher mortality rate than those who live closer. People living in rural areas often must drive hours for their life-saving dialysis treatments multiple times a week, and unfortunately, rural dialysis centers offer fewer opportunities for home dialysis than urban centers.

Preventing kidney failure is key. To be successful, prevention efforts must address two of the main causes of the disease: diabetes and hypertension (high blood pressure), both of which occur at higher rates in rural areas than in urban ones. About 47% of new kidney failure cases are due to diabetes and 29% are due to hypertension. Compared to urban areas, 17% more people per capita have diabetes in rural areas and the rates of hypertension cases are 10% higher.

The CARE for All Kidneys Act of 2021, bipartisan legislation introduced by U.S. Reps. Lisa Blunt Rochester (D-DE) and Brad Wenstrup (R-OH), will take steps to prevent kidney failure in rural areas.

The bill first calls for a study of the causes of kidney disease and kidney failure. If the bill becomes law, the National Institutes of Health (NIH) would be directed to research these causes, including socioeconomic, geographic location, clinical, environmental, genetic, racial, ethnic and other factors that contribute to the social determinants of health in rural and other underserved areas. After conducting this study, NIH would provide a report to Congress, detailing the ways to address kidney disease and kidney failure in rural communities, underserved communities and communities of color. The report would explain why kidney failure affects these communities at higher rates and would also provide guidelines for prevention, data collection, ways to educate the public about kidney disease, and training and education programs for health care professionals.

After submitting the study report, the CARE for All Kidneys Act calls for a national action plan. The Department of Health and Human Services would be directed to work in consultation with patients, caregivers, health professionals, patient advocacy groups, researchers, public health professionals and other stakeholders to develop an action plan to address kidney disease and kidney failure in the U.S. The plan would also specifically address the unique needs of people living in rural areas. Once the plan is developed, the National Institute of Diabetes and Digestive and Kidney Diseases would conduct public awareness and education activities, including educating primary care physicians and other health care providers about kidney disease and who should be screened. Ninety percent of people with kidney disease do not know they have it. The Centers for Disease Control and Prevention would provide grants to state and local jurisdictions, Native American tribes and nonprofit organizations to help reduce the burden of kidney disease. People who live and work in rural areas will have public awareness campaigns targeted to them in effort to help people learn how to prevent kidney failure.

Please click here to contact your U.S. representative and ask that they support this legislation.


Deborah Darcy

Deborah Darcy is the senior director of government relations at the American Kidney Fund.