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VistaSure™, at home augmented reality screening toolkit for Chronic Kidney Disease

In the United States, more than one in seven adults, about 35.5 million people, are estimated to have chronic kidney disease (CKD). Even more concerning, as many as nine in ten adults with CKD, and about two in five adults with severe CKD (stage 4), do not know they have CKD. CKD is more common in people aged 65 years or older, slightly more common in women than men, and has a high prevalence in non-Hispanic Black adults (20%), Hispanic adults (14%), non-Hispanic Asian adults (14%), and non-Hispanic White adults (see Figure 1). [1]

Figure 1. Data from the CDC, including CKD stage 1-4 using data from the 2017 - March 2020 National Health and Nutrition Examination Survey, utilizing single measure of albuminuria or serum creatinine. [1]

Risk factors for CKD include diabetes, hypertension, heart disease, obesity, a family history of CKD, inherited kidney disorders, and past damage to the kidneys [1]. Approximately one in three adults in the United States with diabetes has CKD, and one in five adults with high blood pressure has CKD [1].

In the setting of the worsening obesity epidemic, the prevalence of CKD and of various diseases related to CKD in the United States is increasing. Renal health is closely linked with obesity, metabolic health, and cardiovascular health. Lhoste et al. published recently in Nature Cardiovascular Research that cardiometabolic and renal traits of the US population have shifted from phenotypes with high blood pressure and cholesterol toward poor kidney function, hyperglycemia and severe obesity [2]. There has been a recent body of literature with strong support by the American Heart Association describing cardiovascular-kidney-metabolic (CKM) syndrome, with 10 year mortality rates for adults with both diabetes and CKD exceeding 30% [3, 4].

Although there have been many changes to insurance coverage of screening tests in the last decade, the reality is that many people do not have the time, knowledge, access, or trust in the healthcare system to obtain timely screening. Furthermore, primary care physicians and providers are limited by long wait times for clinic appointments, short visits, and limited resources to screen high risk patients. There is a large body of evidence that demonstrates that rates of CKD and CKM disproportionately affect populations with high social deprivation index (SDI) scores (a composite metric describing socioeconomic status using a variety of factors) and non-metropolitan counties [5].

CKD is often asymptomatic in early stages, and even in later stages, which makes timely diagnosis all the more important. Early intervention results in delay in the need for dialysis, which is costly and time consuming. Early detection of CKD is a huge healthcare challenge in the United States. Medicare spending for CKD, not including end stage kidney disease for ages 66 or older exceeded $75 billion in 2020, which accounts for 25.2% of Medicare spending in this age group. An additional $50.8 billion in Medicare-related spending was for beneficiaries with end stage kidney disease. [6]

Our novel approach to screening for CKD is to do it in the comfort of a patient’s home. There is a range of tests that primary care providers use to initially screen for CKD, including urine albumin. In combination with Vista Probability AI Analysis Tool for Healthcare (V-PAATH), VistaSureTM is an innovative tool for population screening of CKD, particularly for patients with high social determinants of health needs and poor access to the healthcare system.

Sandy Liu, MD FAAP

Chief Medical Officer

Vista BioMedical, Inc.