Legislative update: The Senate Better Care Reconciliation Act

By Troy Zimmerman, National Kidney Foundation’s Vice President of Government Relations

On July 13, Senate Republican leaders unveiled a revised version of their healthcare reform bill.  Previously, the National Kidney Foundation stated its opposition to the Senate Better Care Reconciliation Act, as it would reduce access to preventive and life-saving care for people at risk of, or with, chronic kidney disease.   We remain opposed to this bill despite the latest changes.

Most significantly, the new bill allows insurance companies to offer plans that are non-compliant with the Affordable Care Act as long as those companies continue to also offer plans that are ACA-compliant in the same geographic area.  Many observers, including the National Kidney Foundation, believe this would result in younger, healthier people enrolling in non-ACA compliant plans, making the ACA-compliant plans, which offer more benefits, unaffordable.

Furthermore, the revised proposal includes reductions to Medicaid similar to those in the first reform bill, which could leave many low-income people without access to health insurance and health care services, including preventive care necessary for slowing the progression of chronic kidney disease. As state Medicaid budgets are tightened, states might reduce the populations they cover and eliminate expensive benefits such as dialysis treatments.

We are opposed to the bill for reasons stated above and the potential impact on individuals with kidney disease.  If you would like to write your Senators and express opposition to the bill you can do so by clicking here.

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Senate Introduces the Better Care Reconciliation Act

By Troy Zimmerman, National Kidney Foundation’s Vice President of Government Relations

On June 22, the U.S. Senate introduced the Better Care Reconciliation Act, their counterpart to the House of Representative’s American Healthcare Act.  Both bills would significantly reduce access to vital, preventive, and life-saving care for people at risk of, or with, chronic kidney disease.

Despite assurances that people with pre-existing conditions could still purchase insurance in the Marketplaces, this bill allows states to eliminate the essential health benefits currently provided under the Affordable Care Act, and permits insurers to discriminate against people with pre-existing conditions by not covering vital medications and treatments. For kidney patients, this could include treatments such dialysis or transplantation and medications.

In addition, significant changes and cuts to Medicaid could leave many low-income people without access to health insurance and health care services.  This includes preventive care necessary for slowing the progression of chronic kidney disease.  As state Medicaid budgets are tightened across the nation, states may look to reduce the populations they cover and eliminate expensive, but critical, benefits like dialysis treatments.

Instead, NKF believes the Senate should consider these alternative concepts to improve healthcare for chronic kidney disease patients:

  • Access to healthcare is critical to earlier detection and management of chronic kidney disease (CKD). Earlier detection and management can often delay or prevent progression of chronic kidney disease and the need for dialysis treatment, improve outcomes for patients and lower healthcare expenditures.  NKF urges Congress to enact policies that maintain or increase the number of insured patients, which will enable earlier detection of CKD.
  • People with end stage renal disease (ESRD) require either a kidney transplant or dialysis to survive.  As such, insurers should be required to cover these treatments and be prohibited from limiting coverage to people with ESRD who choose not to enroll in Medicare.
  • Over 200,000 ESRD patients have received a life-saving kidney transplant and must take immunosuppressive drugs for the life of the transplant.
    • The insurance practice of placing immunosuppressive medications, including generics, on high cost sharing tiers requiring coinsurance amounts of greater than 20% and up to 50%, while also excluding generic immunosuppressive medications from fixed copayment amounts, severely jeopardizes the long-term success of the transplant.
    • Cutting back on, or skipping doses of, immunosuppressive medications can be detrimental to the transplant and the patient.
    • Each year Medicare spends $87,000 per dialysis patient; opposed to $32,500 for a transplant patient.  Transplantation is far more cost effective and is associated with better outcomes than a lifetime of dialysis.

If you are interested in supporting NKF and kidney patients around the country, please consider reaching out to your Senators by clicking on the button below.


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At Home This August? Consider Meeting Your Legislators!

By Andrew Fullerton, Government Relations Manager

Will you be around this August and want to help make a difference for patients?    Consider taking a few hours to meet with your lawmakers (or their staff) to tell them about the importance of kidney disease legislation and programs!

From July 29th to September 4th, Congress will be on what is commonly called “August Recess.”  Your Senators and Representatives will be in their home state meeting with constituents.  There are a number of ways that you can meet with them:

  1. Meet with them in their district offices.
  2. Speak with them at town halls.
  3. Speak them at local events they are attending.
  4. Already have a relationship or met with them recently? Follow-up by phone or email.

With any of these options, remember that you are the expert with a story to tell, so it’s your job to emphasize the impact of chronic kidney disease (CKD) on the people in your state and district.  Keep it local and make it personal!  Keep in mind to invite your local NKF staff to participate and share details about your meeting with me (Andrew.Fullerton@kidney.org).

Meeting them at their office

Why set up a district meeting at the office? 

Simply, you get the most “bang for your buck.”  You get time with your legislator, or their staff, in a quiet setting and have their attention solely on you.  Building a relationship with your legislators and their staff will yield concrete benefits and set the stage for ongoing discussions.  Typically, they will dedicate 15-30 minutes to meet with you and discuss topics important to you.

How do I go about this?

Every lawmaker has at least one district or state office and many have two or more.  First, read this short guide.  Then call or email your legislator’s district office (Who are your legislators? Click here) and ask to schedule a district meeting.  Tell them what you would like to discuss and who will be joining you for the meeting.

What should I talk about? 

Your story is the first thing to talk about!  You are the expert on living with CKD and you are the inspiration.  Then, talk about policy topics related to CKD that interest you.  I suggest discussing the Living Donor Protection Act (H.R. 1270) and living donation; early detection and management, or funding research and other programs related to CKD.  Talk about how CKD and policy topics, like the above, impact constituents in their district or state.  Use the state CKD fact sheets here.  Consider inviting your legislator to attend an upcoming NKF event or a CKD related facility, such as a dialysis or transplant center, next time you go.

Who else should I invite to join me?

Contact me (Andrew.Fullerton@kidney.org) or your local NKF office.  We would love to participate or find others to join you!  Also, consider inviting your local Kidney Advocacy Committee members to join you.  Finally, don’t forget that you probably have friends with CKD, your family who helps care for you, and others involved in your care that you can invite.

Anything else I should do?

Follow up!  Make sure to send a thank you note by email and a handwritten thank you.  Keep in regular contact and offer to be a resource for their office.  Send them leave behinds on the issues and impact of CKD in your emailed thank you.  Also, communicate about your meeting on social media. Post a picture of you at the meeting with a thank you.  Put in a line about your discussion of CKD and legislative policy.   Share this with their office.

Town Halls

If you have been reading or watching the news, you have seen an article about town halls held by lawmakers.  These can often be contentious events, but are an excellent opportunity to discuss CKD policy and issues in a public setting.  They also allow you to participate with a large number of kindred souls who want to advocate for kidney patients.  These events are often in-person, but can also be on Skype, via conference call, on Facebook, or other mediums.

How do I find out about town halls?

There are numerous ways.  The best is to sign up on your lawmaker’s mailing list.  There are various online resources, such as the Town Hall Project, that collect information about upcoming town hall events.  Your local newspapers may also list upcoming town hall events in their local news and events section.

How do I separate myself from the protesters?

First off, be friendly and polite. Being combative or frustrated can cause your message to get lost or lose its impact.  Thank them for their service, even if you don’t agree with them or their politics.  Like an office meeting, have a short elevator pitch that tells your story and make sure you have specific asks and/or good questions.  If they have supported CKD legislation or joined the Congressional Kidney Caucus, be sure to thank them for doing so!  If you are attending with others, be sure to support each other by applauding after your fellow attendee finishes speaking.

Also, arrive early!  Town halls are very well attended now, so as a result, it is harder to get in – let alone get a good seat.

Are there other things to consider?

One benefit to a town hall event is that there will be reporters on scene.  Consider taking a moment to introduce yourself to them.  Share your story with them and why you are there.  If you would like help preparing for this, contact us.  Please also be sure to invite your local NKF staff, friends, family, supporters, doctors, and others who can talk about CKD and its local impacts.  Finally, consider recording your lawmaker’s responses to your questions and sharing those with NKF staff.

Other local events

Town halls are not the only local events that lawmakers go to.  You may also find them at county or state fairs, job fairs, ribbon cuttings, or other large public events. Lawmakers’ offices often will have a booth at events like county fairs, where they (or their staff) will meet with constituents.  This is a great opportunity to speak with them in an informal setting.

Are you a member of a Chamber of Commerce, VFW or Legion post, Kiwanis or Lions Club, or other similar organization that hosts large events?  Is your membership organization hosting a monthly meeting or other big event?  Consider inviting your legislators to meet with and address your group at the event. This is a great opportunity to create your own opportunity to meet and interact with your lawmakers.

For these events, many of the same rules apply that were discussed in the town hall section above.  Be polite.  Have an elevator pitch with your story and requests.  Have questions prepared ahead of time.  Invite others impacted by CKD to come.  Invite the local NKF office to participate!

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30 million Americans with CKD: Action is Needed Now

An estimated 30 million Americans are affected by chronic kidney disease (CKD) and most do not even know they have it.  This newest data comes from the Centers for Disease Control and Prevention’s (CDC) CKD Surveillance Program and is higher than previous estimates.  This reflects that 1 in 7 Americans have CKD and that most of it is going untreated. This should serve as a warning alarm that we need changes to our healthcare system to promote and improve earlier detection and treatment of CKD and to invest greater Federal dollars in public awareness and programs that address this largely ignored public health challenge.

An estimated 1 in 3 Americans are at risk of CKD due to diabetes and hypertension.  Early detection and treatment can delay or prevent progression to end-stage renal disease (ESRD) and potentially reduce risk of cardiovascular events and death in those with CKD. However, our health care dollars and our system is focused predominately on treatment of ESRD. An additional and equal focus on addressing CKD early on is needed.  Earlier detection and treatment also allows those that will ultimately progress to ESRD the opportunity to receive education on treatment options, including opportunities to avoid dialysis by receiving a pre-emptive transplant or electing to do dialysis at home.

The National Kidney Foundation is committed to engaging key policy makers, health insurers, and health care professionals on specific solutions to address this public health challenge.  These include:

  1. Promoting CKD early detection, treatment, and awareness within public programs and initiatives that focus on diabetes, hypertension and heart disease
  2. Aligning health insurance reimbursements to clinicians with improved early detection and treatment of CKD in those at risk and with the disease.
  3. Creating greater opportunities for patients who progress to ESRD to receive a kidney transplant
  4. Investing Federal dollars into research and programs that tackle this substantial public health challenge

Will you join us in our effort to make CKD a public health priority?


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The 6th Annual Cocoa Beach “Footprints in the Sand” Kidney Walk celebrates Florida Living Donors Day

Posey and HahnBy Bill Hahn, National Kidney Foundation Kidney Advocacy Committee member and “Footprints in the Sand” Walk co-founder and chair


COCOA BEACH, FLORIDA: On Saturday May 13th, 2017, we proudly saluted our selfless Florida Living Kidney Donors and celebrated the gift of life through organ, tissue, and eye donation.

Congressional Surf Shot

Left  to right: Bill Hahn, kidney recipient & KAC member; Senator Debbie Mayfield; Representative Thomas Goodson; Phil Salick, living kidney donor; Katie Posey; Congressman Bill Posey; Kevin Sackett, NKFF board member; Jennifer Tharpe. 

Congressman Bill Posey, State Senator Debbie Mayfield, and State Representative Thomas Goodson shared the day, and walked the walk by joining hands with hundreds of families in the “Gift of Life Journey.” Congressman Bill Posey – a member of the Congressional Kidney Caucus, co-sponsor of the Living Donor Protection Act, and Honorary Walk Chairman – once again led the way as he has done since the Walk’s inception in 2012.  At the kick-off ceremony, Posey said, “it is both humbling and educational to walk alongside donor families, living donors, and recipients, hear their stories and share with the participants.

The Cocoa Beach Kidney Walk was founded by Richard Salick and myself, patient advocates, and fellow professional surfers.  When we founded the Walk, we wanted to share the stories of every person affected by our shared journey. We knew it had to be special, and that’s why we honor our donor moms with the “Starfish Donor Mom Legacy Dinner” the evening before the Walk. That evening we also paddle-out unified into the “Circle of Life” with living donors and recipients, we recognize our dialysis patients with our “You Are Not Alone Award,” and build “Sandcastles of Hope” for our littlest kidney warriors.

What Rich and I envisioned when we created the Walk in 2012 is becoming a reality—we wanted to help others share each path traveled to the gift of life. This year was especially gratifying as our state legislators came on board by making “footprints in the sand” a symbol of solidarity with patients and their families, interacting first hand with our front-line patients and their families, and listening to the real impact their actions can have to their patient constituents.  We had invited our state legislators to “walk the Walk,” and experience face to face the joys, sorrows, and the financial and insurance issues patients face just to stay alive. They now understand that making your “footprints” is about making a difference.


Sen. Debbie Mayfield presenting the proclamation

This year, the Florida Senate passed S.R. 1836, establishing the Florida Living Kidney Donors Day. Senator Debbie Mayfield stated, “the 2017 Cocoa Beach Living Kidney Donor Day Walk was my first Walk and definitely not my last. It was an honor to present the Living Kidney Donors Day Resolution to Mr. Hahn, the Co-Founder and Chair of the Cocoa Beach Kidney Walk. It was humbling to see the graciousness of those who have lost loved ones and the living kidney donors who have given a second chance to the families of loved ones that they touched.”

Talking with our legislators in this open environment was a great way to broach the serious life and death issues that we as CKD patients, living donors, and our families must deal with on a day in and day out basis.

Candace Mattox, a dialysis patient and speaker said, “the entire weekend was

Candace Mattox

Candace Mattox

emotional. Getting to hear all sides of organ donation is an amazing experience. It was amazing what some people are doing with their second chance at life. I wish there was a way to get that message out to people who are not organ donors. I’d love to be able to show them what people can do when given a normal life again.” Candace is due to receive a living kidney donation in July.

I can’t thank our legislators enough for opening their eyes, ears and hearts, and for the supporting and honoring our Florida living kidney donors in such a moving way. Now, it’s time to take the next step and make our next “footprint in the sand” by passing the Living Donor Protection Act.

Honor and protect our living kidney donors.

See additional coverage on the 2017 and previous “Footprints in the Sand” Kidney Walks:

NKF Surfer’s Story – My story

2017 – Florida Living Kidney Donors Day. Cocoa Beach Kidney Walk

2017 – Build a Sandcastle of Hope – Donate Life

2017 – Starfish Donor Moms Legacy Dinner

2016 – Congressman Bill Posey on the Living Donor Protection Act

2016 – National Kidney Foundation – Footprints in the Sand Kidney Walk

2015 – NKFF Cocoa Beach Foot Prints in the Sand Kidney Walk, You Are Not Alone! – Jaime was transplanted after this video

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Friends of NIDDK, Congressional Diabetes Caucus, and NKF Highlight the Value of Scientific Research for Chronic Disease Patients


David White (NKF)

By David White, National Kidney Foundation (NKF) Kidney Advocacy Committee member 

On May 18, I joined representatives of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), patient groups, and other stakeholders in briefing the House of Representatives’ Appropriations Committee staff on the importance of NIDDK’s research and educational programs.  Other panelists included Dr. Griffin Rodgers, Director of NIDDK and Dr. William Cefalu, Chief Scientific, Medical and Mission Officer of the American Diabetes Association (ADA).

NIDDK conducts, supports, and coordinates research on many of the most serious diseases affecting public health at each step of both disease progression and treatment.  The hour-long panel discussion highlighted innovative research developments at NIDDK.  We discussed the importance of funding NIDDK’s research for patients with chronic diseases and the impact it will have on patients with diabetes and chronic kidney disease (CKD).  NIDDK has laid the groundwork for advances in personalized medicine and treatments, new medications, organ-related stem cell research, and artificial organs.  It has also taken a leading role in outreach to minority communities in an effort to reduce racial disparities, educate these communities about research, and involve community members in research and medical trials.

My kidneys failed in 2009, and when I saw how advocating for my own health changed my life I decided to do the same for as many people as possible. My advocacy led me to opportunities to participate in numerous panel discussions and trials, and I’ve seen the impact that both can have on our treatments and quality of life.  I’m alive today thanks to research, and I do my best to return the favor by becoming more involved in clinical research and making it easier for more people like me to get involved.

When I speak with friends and relatives about participating in clinical trials, however, many reject the idea immediately for various and sometimes unspoken reasons. Barriers to participation in research by minorities – such as fear and mistrust – must be addressed, and to be addressed they have to be acknowledged. We need to be more innovative in our attempts to contact the hard-to-reach. More funding directed to NIDDK and NIH would create more opportunities to address this culture gap.


Left to Right: Dr. William Cefalu (ADA), David White (NKF), Dr. Griffin Rodgers (NIDDK)

Increased funding also is needed so that more researchers can investigate ways to stop the onset and progression of kidney disease, and provide solutions to reduce this cost burden to our healthcare system.  Additionally, more funding should be directed to engage more people from every walk of life in enhanced and targeted research that will deliver improved detection and treatments to patients. Smart investment now will result in more jobs in the healthcare sector, a better quality of life for millions, and a healthier population.

About David White

Residing in Hillcrest Heights, MD, David is a veteran of in-center nocturnal and peritoneal dialysis and received a kidney transplant in 2015. He is pursuing a degree in health systems management at the University of Maryland and has studied at Yale University. He is a member of NKF’s Kidney Advocacy Committee and recently spoke to the organization’s Council of Advanced Practitioners at the NKF 2017 Spring Clinical Meetings.  He also serves in many other capacities, including PCORI’s Advisory Panel on Patient Engagement, the Veterans Transplantation Association Board of Directors, and as interim chair of the Kidney Health Initiative’s Patient and Family Partnership Council.  David enjoys presenting about kidney disease awareness and patient engagement and has made regional and national television appearances as an advocate.

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NKF’s Hosts Patient-Driven Research Stakeholders’ Conference at 2017 Spring Clinical Meeting – A Conference Where #PatientsDecide

On April 22, 2017 in Orlando Florida, the National Kidney Foundation (NKF) hosted the first effort to identify patient-led kidney disease national research priorities by bringing together over 100 individuals representing  kidney patients of all stages, dialysis patients, kidney transplant recipients, living kidney donors and potential living donors, and kidney donor families as well as physicians, social workers, nurses, technicians, pharmacists, dietitians, caregivers, stakeholders, and academics. The Stakeholders’ Conference was funded through a Patient-Centered Outcomes Research Institute (PCORI) Eugene Washington PCORI Engagement Award.  The ideas and solutions developed during this conference will help NFK further define its role as an organization in facilitating patient involvement in chronic kidney disease (CKD) research.

Teri and Derek

Conference’s co-chairs (Derek Forfang and Teri Browne, PhD, MSW, NSW-C), an example of how patients and researchers can collaborate, as a team

The conference truly embodied how patients and researchers can work collaboratively to address questions most important to kidney patients. Over the course of a year, patients and stakeholders have been true partners throughout all phases of this conference project; from planning, shaping the agenda, and leading the conference activities. Patients, caregivers, researchers, and stakeholders shaped the agenda through their responses to a survey assessing their experiences and challenges in patient-centered research. The conference was also facilitated by both a patient from NKF’s Kidney Patient Advocacy Committee (Derek Forfang) and researcher (Teri Browne, PhD, MSW, NSW-C) and featured patient, caregiver, and researcher panel discussions and a breakout working group session.

In the coming months, NKF, using results from the conference, will establish a list of recommendations on ways that patients, their families, and caregivers can be active participants in kidney disease research processes; and identify a research topic that will be supported by NKF’s 2018 Research Grant Program.

See below for pictures and Twitter engagement from the day


The National Kidney Foundation thanks you for serving as panelists for the 2017 Stakeholders’ Conference
Patient Panelists: Valerie Bailey, Kevin Fowler, Katina Lang-Lindsey, PhD, LMSW, Bobbi Wager, and Caroline Wilkie
Research Panelists: Michael Germain, MD (not pictured), Jamie Green, MD, Rachel Patzer, PhD, MPH, Wendy St. Peter, PharmD, and Mark Unruh, MD

D. Forfant Tweet

Rachel Patzer and Cynthia Allison

Rachel Patzer, PhD (right) with her research partner and kidney patient advocate, Cynthia Allison (left)

R Patzer Tweet



Conference attendees (patients, researchers, and other stakeholders) worked collaboratively in small breakout groups to identify best practice strategies for actively engaging patients in kidney disease research

The Stakeholders’ Conference was funded through a Patient-Centered Outcomes Research Institute (PCORI) Engagement Award Initiative (EAIN 3456-NKF). For more information visit www.pcori.org
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Legislative Update: House Passes Healthcare Legislation Impacting Pre-Existing Condition Protections

capitol building.PNG

On Thursday, May 4th, the House of Representatives voted, 217-213, to pass the American Health Care Act (AHCA) (H.R. 1628).  The National Kidney Foundation (NKF) remains concerned about the impact this bill could have on healthcare for those with chronic conditions, including the 26 million kidney disease patients in the U.S.

H.R. 1628 will now go to the Senate for consideration.  Senate discussion could start within weeks but a Senate vote is likely months away.  We will keep you updated on the Senate’s consideration and provide recommendations for action at that time.  We hope that you will join NKF in helping to shape their healthcare proposals and protecting patients with chronic conditions from having their healthcare negatively impacted.

For more information, please see our press statement released prior to the House vote.

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Bi-Partisan Agreement Funds Federal Agency Healthcare Programs

static_advocacyOn Sunday, April 30th, the House and Senate leadership reached a bi-partisan agreement to fund federal agencies and programs through the end of September.   We are pleased to announce that kidney disease priorities being supported by the National Kidney Foundation increased or maintained their funding in relation to Fiscal Year 2016.

The CDC’s Chronic Kidney Disease Program, which addresses the social and economic impact of kidney disease, will maintain level funding at $2.1 million.  The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), an agency within the National Institutes of Health (NIH) investigating ways to stop kidney disease and improve treatments, will be funded at $1.87 billion – an increase of $52 million over FY2016.  The Health Resources and Services Administration’s Division of Transplantation (HRSA-DoT), responsible for implementation of national policies and oversight governing the distribution of organs to those awaiting an organ transplant, will maintain funding at $23.55 million.

National Kidney Foundation sincerely appreciates the Congressional Appropriations leadership and the House and Senate Majority and Minority leadership for their efforts to advance and protect the needs of people with kidney disease.

Both houses of Congress will be voting on this funding agreement by Friday, May 5th.

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Congratulations Dr. Shari Ling and Derek Forfang!

Congratulations to Dr. Shari Ling and Derek Forfang!  On April 20th, during the National Kidney Foundation’s (NKF) 26th Annual Spring Clinical Meeting, the Foundation bestowed its highest honors to them.

Dr. Shari Ling CMS

Dr. Shari Ling and NKF President, Dr. Michael Choi

Dr. Ling, the Deputy Chief Medical Officer for the Centers for Medicare and Medicaid Services (CMS) and Medical Officer in the Center for Clinical Standards and Quality (CCSQ), received the first-ever NKF Public Service Award.  This award was established to honor those who have dedicated their careers to public service and who have helped to shape public policies or government programs that improve outcomes for kidney patients. Under Dr. Ling’s leadership, CCSQ has established a culture of meaningful engagement of kidney patients and family in policy solutions that advance the delivery of high quality, person-centered care, across all care settings. The engagement of kidney patients by CCSQ has been touted as a model for how patient engagement should occur more broadly.

Mr. Forfang, a kidney patient and long-time kidney disease advocate, received the first-

Derek Forfang Presidents Dinner

Derek Forfang and Daniel Lee

ever Celeste Castillo Lee Patient Engagement Award, established in honor of Celeste Castillo Lee, a longtime advocate for patient-centered care and empowerment. It is the highest honor given by NKF to a distinguished kidney patient who exemplifies NKF’s mission and Celeste’s legacy of putting patients at the center of all aspects of healthcare. Mr. Forfang, of San Pablo, California, has been an end-stage renal disease (ESRD) patient since 1999.  He is a kidney transplant recipient and has been on peritoneal dialysis and hemodialysis.  A regional leader of NKF’s Kidney Advocacy Committee and a member of NKF’s Public Policy Committee, he works tirelessly to protect and improve care for the kidney community. Derek is very active with the National Forum of ESRD Networks, which advocates for the organizations that monitor the quality of chronic kidney disease, dialysis and kidney transplant care in the U.S.  He chairs its Kidney Patient Advisory Council, just one of a handful of his leadership roles there. He also serves on the Kidney Health Initiative’s Patient Committee for the Development of a Roadmap for Innovations in Renal Placement Therapy (RPT) Project.

In another first at the Spring Clinical Meeting, NKF also erected its advocacy wall, showing the faces of the kidney patients that the NKF and our advocates represent.  Inspired, dozens of doctors, nurses, social workers, and other practitioners signed up to become advocates.

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