Monogram health

A Monogram health care professional helps a patient in her home. 

The number of people with end-stage kidney disease has gone up 42 percent from 2000 to 2019, according to a recent report from the Centers for Disease Control and Prevention. That means at least 760,000 people are in need of dialysis or a kidney transplant to survive. 

There are a few reasons for this jump, said Julia Lewis, professor of nephrology at Vanderbilt University Medical Center. The main causes are diabetes and high blood pressure, which are simply happening at higher rates over the last couple of decades. 

Lewis added that there are some new treatments for kidney disease introduced near the year 2000, prolonging the life of patients who may now be dealing with end-stage kidney disease. Some treatments for cancer and cardiovascular disease can save a patient’s life, but end up damaging the kidneys as well. 

“They end up alive from their cancer that would have previously killed them in probably less than 12 months,” Lewis said. “They live for years, but they might end up on dialysis.” 

Symptoms of kidney disease are slow and gradual to develop, making it harder to prevent the disease from reaching the end-stage. The CDC has reported that as many as 90 percent of people with chronic kidney disease don’t know they have it.  

For locally-based Monogram Health, a kidney care provider, at-home care is a secret to success. The company provides about 25 percent of its dialysis care in the home, compared to the national average of about 10 percent, said Monogram CEO Michael Uchrin. 

“Because of the chronic nature of the disease and the complexity of the disease, the disease affects much more than just the patient. It affects the entire family,” he said. “By being in the home, we're able to not only help educate the patient around dialysis, the machine, how to do it, what's expected, but also as family members who need to support that individual.”

Lewis said there is a lot that can be done to slow the progression of the disease, but patients don’t always have access to medical care or medications and educating them on the disease and how to manage it can be difficult. 

“A layer that's generally true in medicine in our country, which is that based on the social determinants of health, there are many things that we know work, but don't get delivered,” she said. 

California-based Scan Group invested in Monogram last year, and Monogram used that funding to move forward with remote patient monitoring technology as well as launch a location in Phoenix, Az. The company is in 28 states and plans to expand to 34 by the end of the year, Uchrin said. 

It's important not to let perfection be the enemy of good when it comes to diet and lifestyle changes to ultimately prevent or slow down the progression of kidney disease, Uchrin said.

“It's simple, but it's hard,” he said. “If we manage the diabetes, if we manage the hypertension, it will slow down progression. The big thing is education and getting to those individuals earlier on, and creating those evidence based care plans, so that we don't get to kidney failure.”