American Kidney Fund

Roughly 808,000 Americans are living with kidney failure. Of those, more than 556,000 are on dialysis and 250,000 are living with kidney transplants. The number of people who need kidney transplants is far greater than the number of available donor organs. There are more than 90,000 Americans on the waiting list for a kidney transplant, but approximately 28,000 kidneys were transplanted in the U.S. last year.

Kidney failure devastates patients physically, emotionally, and financially. Employment rates for U.S. dialysis patients have been reported as low as 20% because of the time-consuming treatments and impacts of the illness. In 2023, the typical patient AKF assisted with treatment-related expenses had an annual household income of just over $25,000, yet faced out-of-pocket costs of nearly $10,000.

AKF’s financial assistance programs ensure that these patients continue to have access to their lifesaving treatments.

More broadly, AKF is working to educate the public about kidney disease and help people detect it early so they can avoid progressing to kidney failure through disease management education, award-winning public and professional health education materials, courses, webinars, and AKF’s virtual Kidney Action Week.

The American Kidney Fund provides a complete spectrum of programs and services: prevention activities, top-rated health educational resources, and direct financial assistance enabling 1 in 8 U.S. dialysis patients to access lifesaving medical care, including dialysis and transplantation. We also invest in clinical research to improve outcomes for kidney patients and we fight tirelessly on Capitol Hill for legislation and policies supporting the issues that are important to the people we serve.

Kidney disease is striking Americans at a faster rate than any other non-communicable disease. For the 37 million people in the United States who are living with this serious condition, the American Kidney Fund is the trusted nonprofit that is fighting on all fronts—from prevention through transplant. Through our programs that support early detection, disease management, innovation and clinical research, advocacy, and financial assistance, AKF makes a direct, vital impact on more lives than any other kidney nonprofit by delivering support that create pathways to healthier living.

No organization provides the broad scope of vital programs that help people at every step of their journey with kidney disease. Last year, AKF provided direct financial assistance to 1 out of every 8 Americans living with kidney failure.

AKF continued to meet the needs of kidney patients in 2023:

Financial Assistance Programs:

• AKF provided direct financial assistance to more than 80,000 low-income dialysis and transplant patients. We helped over 65,000 patients pay their health insurance premiums so that they could access the health care they need to stay alive, including dialysis and transplant.
• 1,615 low-income dialysis patients had kidney transplants and post-transplant care with AKF’s financial support, representing roughly 6% of all kidney transplants performed in the U.S.—a scope of assistance unmatched in the nonprofit community. Each month, AKF helps 134 people get off dialysis by providing financial assistance that makes transplants possible.Through our Safety Net Program, nearly 8,500 kidney patients were able to pay for transportation to dialysis, nutritional products, emergency assistance and other expenses not covered by health insurance. AKF provided more than $70,000 in disaster relief grants to more than 500 people with kidney failure who were affected by tornadoes in Mississippi, wildfires in Hawaii, Typhoon Mawar in Guam and Hurricane Idalia in Florida.

Clinical Scientist in Nephrology (CSN) Program:

For over 30 years, AKF’s CSN program has supported clinical research to improve the quality of care provided to kidney patients. To learn about the research of our fellows, please visit www.kidneyfund.org/training/clinical-scientist-in-nephrology/.

Advocacy Programs:

Together with our nationwide Advocacy Network of nearly 28,000 Ambassadors, we work with Congress, the administration, federal agencies, state governments and other stakeholders to advance legislation and regulatory policies important to people with and at risk for kidney disease and their families.

Our 2023 policy priorities sought to make more kidney transplants possible, provide equitable access to health insurance and drive innovation in research and treatment. The priorities include:

• Addressing health disparities and advancing health equity
• Improving early detection of kidney disease and addressing the unknown causes of kidney disease
• Fighting insurance discrimination against people on dialysis
• Ensuring adequate funding for kidney research and promoting innovation
• Encouraging organ donation and supporting kidney transplants
• Supporting Medigap reform
• Ensuring access to high quality, patient-centered care for Medicare beneficiaries with kidney disease
• Protecting and enhancing access to health coverage under the Affordable Care Act, Medicaid, and employer-sponsored insurance
• Protecting patient access to needed medications; supporting lower prescription drug costs

In 2023, our advocacy work included:

• Convening advocates for two in-person events on Capitol Hill: the Kidney Action Summit on May 16, with 30 AKF Ambassadors from 17 states and the Rare Kidney Disease Advocacy Day on Capitol Hill, with nine advocates from seven states. These events provided the opportunity for AKF, patient advocates and other stakeholders to urge members of Congress and key staff to support legislation to protect living donors and recognize genetic counselors as health care providers so they can be reimbursed by Medicare, among other bills.
• Supporting the New Era of Preventing End-Stage Kidney Disease Act (H.R. 6790). This bill aims to improve the understanding and timely and accurate diagnosis of rare kidney diseases.
• Supporting the Living Donor Protection Act (S. 1384 and H.R. 2923). This bill would ensure living organ donors are protected from insurance discrimination and can take time off from work after organ donation surgery. 
• Working to expand Medigap to Medicare beneficiaries with kidney failure who are under 65.
• Leading and/or supporting the passage of 21 state bills, including comprehensive Medigap reform in Kentucky and Virginia, living donor protection bills in five states, and biomarker coverage for people with kidney disease in 12 states. 
• Supporting the development of a kidney disease screening recommendation by the U.S. Preventive Services Task Force that could improve early detection of kidney disease.
• Supporting the Chronic Kidney Disease Improvement in Research and Treatment Act of 2023 (H.R. 5027), which aims to improve the lives of those with kidney disease by increasing awareness and expanding preventive services.
• Supporting The Restore Protections for Dialysis Patients Act (H.R. 6860) which would codify Medicare as Secondary Payer policy with regard to employer-plan coverage of dialysis treatment. 

State of the States: Living Donor Protection Report Card

• In 2023, AKF launched its third annual State of the States: Living Donor Protection Report Card, which grades how well existing laws in each U.S. state and the District of Columbia encourage living organ donation and reduce barriers for living donors and tracks our progress in achieving these protections.  
• AKF has led efforts at the state and federal levels to get living donor protection legislation passed for years. The Report Card highlights the need for federal legislation that establishes a uniform baseline of support for would-be donors, as states are currently operating with an uneven patchwork of living donor protection laws
• Thanks to our groundbreaking Report Card, significant progress has been made in the states, moving the national grade average from a D to a C.

• We had more than 530 meetings with congressional and state elected officials’ offices, including 90 virtual in-district meetings with Ambassadors and their local congressional offices. In these meetings, we built important connections with staff and informed them of the needs of the kidney community.
• On April 20, AKF hosted its first Patient Access Initiative (PAI) Summit in Washington, D.C., bringing together stakeholders to discuss barriers to affordable and innovative health care that many people with kidney disease face.  Summit attendees discussed possible solutions to ensure equitable access to quality health care that would help address the crisis in kidney disease. Developed as part of the PAI, we also created a whitepaper entitled, "A Call for Early Diagnosis and Treatment of Chronic Kidney Disease" that summarizes the discussion and calls to action arising from AKF's inaugural PAI Summit.
• In September, we convened our first Rare Kidney Disease Advocacy Day on Capitol Hill, connecting AKF Ambassadors and patient advocates from the IgAN Foundation and health care professionals with lawmakers on Capitol Hill. Representing seven states, nine advocates (all of whom have a rare kidney disease) had 23 meetings with their senators' and representatives' offices, including two meetings with members of Congress in attendance. 
• The 2023 state legislative sessions also produced many positive changes for living organ donors and people living with kidney disease. AKF was involved in passing 21 bills and introducing 13 state-level bills, among them passing comprehensive Medigap reform in Kentucky and Virginia, Living Donor Protection Act bills in Nevada, Wyoming, Michigan, and Rhode Island and Biomarker coverage for kidney disease patients in 12 states.
• AKF staff and AKF Ambassador efforts at the state level included 277 meetings with state lawmakers and their staff, and 26 state legislative hearings in which AKF staff or AKF Ambassadors provided testimony.
• Kidney Action Week: AKF held a virtual Kidney Action Week, to help people understand their risk for kidney disease and how to prevent it through webinars and online activities.
• The Hope Affair: AKF’s annual Hope Affair raised awareness for kidney disease and spotlighted extraordinary patients and friends in the community. 
• Pediatric Support:AKF’s Camp Connections, formerly known as National Virtual Camp, increased its reach and impact, adding seven new partnered hospitals, bringing the total to 12 hospitals and enrolling more than 200 campers from 30 states.  Monthly activities include art classes, bingo and trivia.

Online Resources:

Our online courses are designed to meet continuing education requirements for prescribers and allied health professionals. All courses are developed and peer reviewed by renal subject matter experts.

• Nearly 13,000 of AKF’s continuing education courses were completed by health care professionals and an additional 62,000 viewed our new, non-accredited professional webinar series.
• Nearly 1,300 people received training to become kidney disease educators in their communities, bringing our total number of Kidney Health Coaches nationwide to more than 6,400.
• Our patient newsletter reaches more than 62,000 dialysis and transplant patients quarterly with articles designed to inform and inspire.

We are recognized as one of the nation’s most trusted nonprofit organizations.

• We continue our longstanding record of spending 97 cents of every donated dollar on programs and services.
• In 2023, we received our 21st consecutive “Four Star” rating from Charity Navigator, placing us in Charity Navigator’s “Top 10” list of organizations with the most consecutive “Four Star” ratings.
• In addition, the American Kidney Fund has an “A Plus” rating from CharityWatch, adheres to the National Health Council Standards of Excellence, and is a member of the Better Business Bureau Wise Giving Alliance.