Laura J. Maursetter, MD, discusses why early kidney disease screening and continuity of care are especially critical for justice-involved patients.
For patients with chronic kidney disease (CKD), timing matters. Many of the same risk factors that increase a person's likelihood of incarceration, including poverty, limited health care access, and untreated chronic disease, also raise the risk of developing CKD, according to Laura J. Maursetter, MD, Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health.
Why Early Detection Matters More in High-Risk Populations
Key Facts
"We have so much room to be able to impact an outcome of someone's life if we start earlier," Maursetter told HCPLive, noting that identifying kidney disease at an earlier stage makes a meaningfully bigger difference than catching it later in its course.
She acknowledged that primary care physicians already carry heavy caseloads, but argued that screening high-risk populations earlier is not just clinically sound, but financially justified.
"Being able to look for these things earlier, especially in these high-risk populations, is cost-effective, and that's been shown, as well as outcome-effective," she said.
She also cited recent momentum in the field, including new kidney medications introduced within the past 2 years that have meaningfully extended patient longevity.
Care Disruptions Behind Bars
Maursetter cautioned that clinicians who see justice-involved patients only briefly, either during a single visit or after release, often have little visibility into what patients experienced while incarcerated.
Custody structures vary by facility and can shift a patient's access to medications depending on their housing classification. And it's often unclear, she said, whether patients are self-administering medications or receiving them under supervision, a distinction that matters when doses are missed or prescriptions lapse without being refilled.
What Happens to Care After Incarceration Ends
Patients leaving incarceration often face immediate and compounding obstacles, Maursetter said: reestablishing interrupted medications, securing timely follow-up appointments, and doing so while navigating unstable housing and unreliable transportation.
"I think of the correctional facility as being a time where you're serving your time for the things that you were convicted for, but then afterward, there's so much that follows those patients," she said.
Maursetter called on clinicians and health systems to build flexibility into how they accommodate returning patients — including making room in scheduling for people who could not plan visits in advance. "How can we kind of build a structure to allow for some of those nuances that may not be the same in all of the rest of our patients?" she said.
Editor’s Note: Maursetter reports no relevant disclosures.
