National Kidney Month Highlights Dr. Kirsten Johansen’s Work to Improve Life for Kidney Disease Patients

March is National Kidney Month, a time to raise awareness about kidney disease and the importance of early detection. For Kirsten Johansen, MD, nephrologist and president of Hennepin Healthcare Research Institute (HHRI), it’s also a reminder of the critical role research plays in improving the lives of patients living with kidney disease.

Johansen’s path to nephrology was not straightforward. After college, she spent two years working in liver-related research before deciding to pursue medicine. Once in medical school, she became fascinated by kidney physiology and the complex role the organs play in maintaining the body’s balance of fluids and electrolytes.

“The kidneys are amazing,” Johansen said. “They keep everything in balance – sodium, potassium, fluid levels. That complexity is part of what drew me to the field.”

Early in her research career, Johansen studied muscle wasting and physical function in patients receiving dialysis. During a study in which she administered quality-of-life surveys to patients, she noticed a surprising pattern.

“I was interviewing younger dialysis patients who looked healthy and strong,” Johansen said. “But they would tell me they could no longer do the things they used to do – things like lifting weights or staying active. That really struck me.”

Her research helped show that patients on dialysis are often far less physically active than people with healthy kidneys, a difference that contributes to muscle loss and reduced physical function. This can create a cycle in which kidney disease leads to fatigue and inactivity, which in turn worsens physical health.

That discovery helped shape Johansen’s broader research focus on improving patients’ daily functioning and quality of life.

“Kidney medicine has traditionally focused a lot on numbers – lab values, blood pressure, dialysis measurements,” she said. “But it’s just as important to ask how patients actually feel and what their lives are like.”

Johansen Uses USRDS Data to Help Identify Disparities and Gaps in Kidney Care
In recent years, Johansen’s research has also focused on health disparities in kidney disease. According to the National Kidney Foundation, in the United States, Black Americans develop end-stage kidney disease at roughly four times the rate of white Americans, while Hispanic and Native American populations also experience significantly higher rates.

Researchers are working to better understand the causes of these disparities, which may include differences in access to early care for conditions such as diabetes and hypertension – the two leading causes of kidney disease.

Johansen has also used national data to track broader trends in kidney health through the United States Renal Data System (USRDS). HHRI’s Chronic Disease Research Group (CDRG) administers the USRDS, a national program that collects, analyzes, and shares data on chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States.

As Director of the USRDS, Johansen helps guide the analysis behind the organization’s annual national report on kidney disease. While the report tracks core data such as dialysis use, patient characteristics and mortality, Johansen said the team also looks for trends that can inform improvements in care. That includes examining whether patients are receiving newly available treatments, identifying gaps in access and analyzing how policy changes affect care. Because dialysis is costly, federal payment policies often aim to encourage kidney transplantation and home dialysis.

Johansen said the data can also reveal unexpected barriers. For example, although home dialysis is increasing, many nursing homes are not equipped to support it, forcing some patients to switch to in-center dialysis when they enter a facility.

By highlighting trends like these, Johansen said the report helps researchers, clinicians and policymakers identify areas where changes could improve kidney care for patients nationwide.

“The USRDS is a big nationwide registry of people with end-stage kidney disease, especially, and has since also expanded into chronic kidney disease. So, from there, I started using that data to look at other aspects of care for people on dialysis and with kidney disease and what's going on there.

From Pandemic Impact to Progress in Kidney Disease Treatment
Using USRDS data during the COVID-19 pandemic, CDRG investigators identified a concerning shift. For the first time, the number of people living with end-stage kidney disease in the United States declined. The drop was not due to fewer diagnoses, but to higher mortality rates and fewer people going into the doctor.

These findings helped inform public health responses, including efforts in Minnesota to prioritize COVID-19 vaccinations for dialysis patients and staff in dialysis facilities.

Despite challenges the pandemic brought into healthcare, Johansen says the field is entering an encouraging new era. In the past decade, several large clinical trials have identified new medications that can slow the progression of kidney disease.

“After many years where treatments didn’t seem to move the needle much, we’re finally seeing therapies that can help slow kidney disease,” she said.

However, early detection remains one of the biggest barriers to improving outcomes.

Kidney disease often develops silently, with few symptoms in its early stages. According to Johansen, about 13 percent of U.S. adults (roughly 37 million people) have kidney disease, and many are unaware of it.

That’s why routine screening is especially important for people with diabetes or high blood pressure.

“If we don’t know someone has kidney disease, we can’t treat it early enough to prevent advanced disease,” Johansen said.

National Kidney Month provides an opportunity to encourage those conversations between patients and their primary care providers, including addressing a common misconception about kidney health.

One of the most persistent myths is that simply drinking more water will improve kidney function.

“It's fine if people want to drink extra water,” Johansen said. “But honestly, are they helping their kidneys? Probably not. You should drink when you're thirsty, but there's really no good data that drinking a lot of fluids are good for your kidneys, especially if you have advanced kidney disease.”

For Johansen, the ultimate goal of her work is clear – helping people with kidney disease live longer, healthier lives.

“There’s still a lot we don’t know,” she said. “But the hope is that with better treatments, earlier diagnosis, and more patient-centered care, we can slow kidney disease and help people feel better.”

Related Resources:
- United States Renal Data System (USRDS) 2025 Annual Data Report (ADR)
- United States Renal Data System (USRDS) Interactive Annual Data Report