Building Kidney Health Equity Through Community-Centered Advocacy: Model from the Nephrologists for Equitable Kidney Care (NEKC) Initiative

Background: The Nephrologists for Equitable Kidney Care (NEKC) initiative was launched in 2024 by the National Minority Quality Forum (NMQF) to improve kidney health in underserved communities. NEKC unites nephrologists, clinicians, and patient advocates to reduce risk and improve outcomes for those disproportionately affected by CKD. According to CMS, 25% of Medicare Fee-for-Service (FFS) beneficiaries had CKD in 2020—up from 16% in 2012. Black/African American beneficiaries had the highest CKD prevalence (36%) versus 24% among White beneficiaries. Supported by NMQF’s 5-billion-record data infrastructure, NEKC targets ZIP codes with high disease burden and barriers to care. Methods: NEKC implemented a multi-faceted advocacy strategy focused on: Empowering nephrologists and communities through educational campaigns, webinars, and summits; Advocating for patient-centered reforms that address systemic inequities; Guiding community outreach using data on social vulnerability and CKD prevalence; Developing a mentorship pipeline for students committed to health equity. Target regions were selected based on Medicare CKD rates exceeding 27%. Results: Between August 2024 and May 2025, NEKC: Led coalition letters to CMS and Congress opposing harmful ESRD bundle changes; Amplified patient narratives in meetings with CMS and Congressional leaders; Hosted a national webinar on patient-centered kidney care (200+ views); Engaged 70+ nephrologists and 500+ community participants; Provided kidney health education to 100+ at-risk individuals at health fairs; Partnered with 10+ kidney-focused organizations to expand outreach; Collaborated to expand a mentorship initiative for medical students from underrepresented communities; Co-developed a cross-disease framework to improve cardio-kidney-metabolic (CKM) care. Conclusion: NEKC exemplifies how advocacy-driven, community-centered models can advance optimal kidney care. By equipping nephrologists to engage, educate, and advocate, NEKC is reshaping outcomes for historically marginalized communities while building sustainable infrastructure for equity in kidney health. Funding: Commercial Support - Ardelyx