The Evolving Nephrology Landscape: Treatment, Innovation, and Policy: Part 2

 Key Takeaways

• Kidney disease research has historically received substantially less federal funding than other major disease areas, highlighting the need for greater investment in innovation, research, and treatment development to improve outcomes and reduce longstanding disparities in kidney care.
• As genetically targeted and other novel nephrology therapies emerge, equitable access must remain a priority. Existing disparities in kidney transplantation by race, ethnicity, and sex underscore the importance of policies that prevent unequal access to new treatments.
• Collaboration among professional societies, patient advocacy groups, policymakers, and payers will be critical to advancing kidney health equity. Ongoing bipartisan interest in expanding innovation and treatment access suggests growing recognition of the need to address disparities across the kidney care continuum.

In part 2 of our interview with Suzanne Watnick, MD, she discusses the need to ensure that emerging nephrology therapies, including genetically targeted treatments, are accessible to all patients. She highlights longstanding disparities in kidney care, the importance of increasing investment in kidney disease research, and the role of policymakers, advocacy organizations, and healthcare stakeholders in advancing equitable access to innovation across the kidney care continuum.

What actions can the broader health care community take to ensure new nephrology treatments—including genetically targeted kidney therapies—don’t exacerbate disparities in care?

Suzanne Watnick, MD: There has been an incredible lack of investment in the kidney care community for a number of reasons. If you look back historically, in terms of federally funded research for kidney care, on average, per person with kidney disease, the federal government has spent $19. That's less than a $20 bill per person per year with kidney diseases vs an order of magnitude more. So, we're talking $430 plus for those with cancer and $2700 plus for those with HIV and AIDS per year.

We don't want to take away from those with HIV and AIDS and for those with cancer. There have been incredible changes and improvements in care in these areas. In the 90s, there was not a lot available in terms of the care environment for people with cancer, HIV, and AIDS. Since then, the entire field has changed. HIV/AIDS has really turned into a chronic illness. There are also many cancers that we now have cures for.

So, first and foremost, there are disparities when treating people with kidney diseases vs other disease states. So, we need to invest in closing these gaps. There are initiatives currently underway to try to get further investment, both from the federal government and from private entities. For example, the whole kidney community came together to advocate and create an important report called the Transforming Kidney Health Research Initiative and Report. Many groups within the kidney community, including the American Society of Pediatric Nephrology (ASPN) and ASN, as well as patient organizations such as the National Kidney Foundation and the American Kidney Fund, collaborated to try to improve the treatment environment.

Among newer therapies that are on the cusp of coming into the kidney care space, there aren't a lot of genetically targeted kidney therapies, As they come into the space, we want to make sure that everybody has access. Many people have looked into access and kidney care and found that there are disparities. For example, various studies have shown substantial disparities in kidney transplants. In addition, studies have found Black patients get transplanted less so, even after adjusting for various factors vs white patients. Similar findings have been found for Hispanic vs non-Hispanic patients. Even women have lower access to transplants vs men.

As we move into the age of genetically targeted kidney therapies or any kidney therapies, it's important that people have access to these therapies through appropriate policies and to make sure patients are not discriminated against based on age, gender, race, or any other factors that have traditionally resulted in disparities.

This brings it right back to the policymakers. We've brought this issue—ensuring equitable access to kidney care—to policymakers during the Ways and Means hearing on March 18, 2026. At the hearing, we spoke to the Ways and Means Committee, and from a bipartisan perspective, people supported an appropriate investigation, a push for innovation, and more access to treatment for patients.

Many representatives from different geographic regions— including rural, non-rural, West Coast, East Coast, and central part of the US—shared that their specific concerns about making sure all of their constituents had access to medication. So, we don't have an answer yet, but people at least have a lens and that is a start.

Watch Part 3 of the interview here.