Laura Maursetter, MD

face a system with few tracking mechanisms, inconsistent access to medications and specialists, and steep barriers that don't disappear at release. 

Laura Maursetter, MD, of the Division of Nephrology at the University of Wisconsin School of Medicine and Public Health, has spent her nephrology career caring for incarcerated patients and is calling for standardized screening, treatment, and transplant access across the carceral system. In an interview with HCPLive, Maursetter discussed the gaps she's observed, why early identification matters so much in this population, and what she'd like to see change.

Q&A: For Incarcerated Patients, Kidney Care Can't Wait, With Laura Maursetter, MD

HCPLive: What prompted you to write this call to action on nephrology care for incarcerated people?

Maursetter: I have been fortunate to take care of incarcerated persons for my whole nephrology career. At first it seemed like an add-on, but it has turned into something that has a lot of meaning for me, both in the connection with patients that I have, and in the idea that our kidney patients in general come from socioeconomically disadvantaged groups, and this is not an exception. Being able to see that we deliver care in a way that's just and good is something I have a lot of passion for, and there's a lot of room for improvement in this area. A lot of clinicians who see maybe one or two patients don't have the opportunity that I've had to deliver a more holistic view of care. In doing so, it's been really fun to dive in and see what kind of changes we can make. As a field, demanding some quality standards be implemented, so that post-incarceration, people have the opportunity to be taken care of in a way that is good, and we didn't miss the boat during the time they were incarcerated, is a really important factor.

HCPLive: What are some of the biggest challenges patients who are incarcerated with chronic kidney disease (CKD) face in accessing care?

Maursetter: There aren't a lot of standards implemented in the Department of Corrections. They have access to most medicines and the care that's needed, but depending on the time they're serving, the delivery of care may be a little more variable. They have a tough situation, and I don't want to discount that at all. It is really hard to have a limited amount of resources to spend on a large population, just like we see in most other health care systems. That same challenge happens, and it's maybe more enhanced in the Department of Corrections. There's not really any sort of tracking system to see what percentage of CKD patients are being seen by a nephrologist, whether people are getting all the labs done that they should, or whether we're starting people on all the medicines they need to be started on. That kind of tracking system isn't implemented, which makes it really hard to know what the holistic picture looks like. Research is hard to do in the Department of Corrections because of ethical questions, and sometimes people just exclude that population, and then we miss the boat on being able to know more about what that population looks like.

HCPLive: A lot of the risk factors for incarceration also increase the risk of CKD. What should clinicians understand about the kidney health disparities that affect this population?

Maursetter: We have so much room to impact the outcome of someone's life if we start earlier. Being able to pick these things up at an earlier stage makes more of a difference down the road than if we find them much later in the course of disease. It's unfortunate because primary care doctors have so much on their plates, but looking for these things earlier, especially in high-risk populations, is cost-effective, and that's been shown, as well as outcome-effective. We've got medicines in the last 2 years in the kidney field that have really made an impact on longevity, so being able to make that happen for folks is such an exciting time.

HCPLive: Many clinicians treating this population aren't as ingrained in the process. What should those clinicians be aware of when treating this patient population?

Maursetter It's a particularly challenging group. During incarceration, I had no idea what the structure looked like and what people go through, or what it means to have different types of holdings, where sometimes people are put into different structures within the correctional facility, and that may change access to medicines. There are differences in the diets available, and each institution can be different. It's difficult to know exactly whether they take their medicines themselves or are given them, and who's watching that. Medicines can run out and not be refilled, and those types of things can be a challenge while they're in the facility. When people leave the incarcerated situation, there are so many challenges that we impose on them. I think of the correctional facility as a time where you're serving your time for the things you were convicted for, but afterward, there's so much that follows those patients: getting their medicines, having space to be seen in clinic in a more rapid fashion because they hadn't been able to schedule. I think we as a community can make a little bit of accommodation to help these folks out, have some space in clinic, realize that they may have unstable housing or difficulty with transportation. How can we build a structure to allow for some of those nuances that may not be the same for the rest of our patients? Granted, there are lots of folks that go through challenges, but these are particularly difficult.

HCPLive: What changes would you most like to see in the carceral health system to improve kidney care for incarcerated patients?

Maursetter: Some changes that can be really impactful are identification and education, for both the primary care doctors and the patients, to know how important this is. I am so lucky to have the chance to talk to some people even early in their kidney disease, where they may not even have to follow up with me, but I can share information about how important it is for them to control their blood pressure or change the way they're eating. Who knows if they can continue that outside of their correctional facility situation, but at least they've been told. I would love for us to implement standards so that, just as it's common for people to have their cholesterol checked, why not their kidney function and protein? At what point can we get nephrologists involved, and we should have some guidance to make that as easy as possible for people. And there should be standards with regard to transplant. It shouldn't be variable across different states and institutions; it should be consistent as to what kinds of opportunities we're providing to people. Your sentence duration shouldn't impact your outcomes later, so can we figure out ways to standardize what happens so a person doesn't have to wait and be on the transplant list much later than they would if they were not incarcerated?

HCPLive: Was there anything you felt was important to add?

Maursetter: One interesting part is that our medical school is doing a much better job of creating curriculum around educating our learners about the Department of Corrections. This has been run through the inpatient services, the outpatient services, and then they spend time rotating in some of the specialty services as well, so they have more comfort with what happens in those situations and could potentially be better caregivers in the future. I'm not sure how standard that is in many medical schools, but being able to do something like that would be an advantage in how we care for a different type of population, just as you might think about pregnant women or other specific populations.

The kidney community also has a lot of challenges with disadvantaged groups. We have a smaller community compared with GI or cardiology, so it makes us spread quite thin as to the advocacy needed in different populations, especially when those populations are really limited in what they can do for themselves. I think this is a group that hasn't often been recognized. I've been thankful that I've gotten a chance to speak on it at the American Society of Nephrology, and there was a lot of interest shown, but I wonder if there are more opportunities that can happen if we can highlight some of these things, so this is seen as a population that deserves some of our attention as well.

Maursetter LJ. Nephrology care for incarcerated people: a call to action. 

https://www.nature.com/articles/s41581-026-01108-7

CKD Care Gaps for Incarcerated Patients, With Laura Maursetter, MD. HCPLive. Published August 25, 2026. 

https://www.hcplive.com/view/ckd-care-gaps-for-incarcerated-patients-with-laura-maursetter-md

Closing the Gaps in CKD Screening, Transplant Access, and Education for Incarcerated Patients. HCPLive. Published August 29, 2026. 

https://www.hcplive.com/view/closing-the-gaps-in-ckd-screening-transplant-access-and-education-for-incarcerated-patients

Articles

Incarcerated people with CKD experience highly variable care delivery driven by limited resources, absent quality metrics, and inconsistent access to nephrology, labs, medications, diet, and adherence support. Early identification in this high-risk population is both cost- and outcome-effective, particularly as newer kidney-protective therapies improve longevity when implemented promptly. Barriers intensify at reentry, where housing instability, transportation, and clinic access impede continuity. Priorities include standardized screening for eGFR and proteinuria, clearer triggers for nephrology referral, and uniform transplant evaluation and listing practices independent of sentence duration.

A nephrologist outlines gaps in CKD tracking, medication access, and transplant standards across the carceral health system.

For Incarcerated Patients, Kidney Care Can't Wait, With Laura Maursetter, MD

Identification and education, even in a single encounter, can meaningfully change outcomes for incarcerated patients with chronic kidney disease (CKD), according to Laura J. Maursetter, MD, Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health.

Maursetter said she's had the chance to talk with patients early in their kidney disease even when she won't be the one following up with them. She uses those visits to explain the importance of controlling blood pressure or changing diet. "Who knows if they can continue that maybe outside of their correctional facility situation," she said. "But at least they've been told."

Closing the Gaps in CKD Screening, Transplant Access, and Education for Incarcerated Patients

Even single, non-follow-up encounters can deliver meaningful patient education

Kidney function and protein screening are not standardized the way cholesterol checks are

Transplant access and waitlist timing vary by state and institution

Some medical schools are adding correctional health rotations to training

Nephrology's small workforce limits advocacy capacity for this population

Maursetter pointed to a basic inconsistency in routine care: cholesterol checks are common practice, but kidney function and protein screening are not. She wants clearer guidance on when nephrologists should get involved, along with standards for transplant access specifically.

"It shouldn't be variable in my mind across different states and across different institutions," she said. In her view, care should be consistent regardless of where a person is incarcerated — and sentence length shouldn't determine health outcomes. She raised transplant waitlist timing as a concrete example, asking whether incarcerated patients could be kept from waiting longer than they would if they weren't incarcerated.

Medical Schools Are Starting to Fill the Gap

Maursetter said her institution has developed curriculum specifically focused on correctional health, giving trainees rotations across inpatient, outpatient, and specialty services within the Department of Corrections system. The goal, she said, is for future clinicians to enter practice with more comfort treating this population — similar to how medical schools train students for other specific patient groups, like pregnant patients. She said she isn't sure how common this kind of curriculum is at other institutions.

Maursetter noted that nephrology is a smaller field than specialties like gastroenterology or cardiology, which limits the field's advocacy bandwidth across the many disadvantaged populations kidney patients represent. She described incarcerated patients as a population that hasn't been widely recognized within that advocacy effort.

She said she was encouraged by the response after speaking on the topic at the American Society of Nephrology (ASN), and sees room for more visibility. "I wonder if there's just more opportunities that can happen if we can start to highlight some of these things," she said, "so that it is seen as a population that deserves some of our attention as well."

Editor’s Note: Maursetter reports no relevenat disclosures.

. Published online July 28, 2026. doi:10.1038/s41581-026-01108-7

Kumar M, Stauss M, Taylor P, Maursetter L, Woywodt A. 10 tips for providing kidney care to persons in prison. 

. 2025;18(5):sfaf090. doi:10.1093/ckj/sfaf090

American Society of Nephrology. People Living with Kidney Failure in Detention Facilities: Frequently Asked Questions (FAQs). Published March 2026. Accessed August 25, 2026. 

https://epc.asn-online.org/wp-content/uploads/2026/02/Kidney-Failure-in-Detention-Facilities-FAQ.pdf

Videos

Laura J. Maursetter, MD, discusses the case for standardized kidney screening protocols, transplant access, and medical education reform for the correctional population.



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 CKD Treatment Should Start Earlier, Last Longer for Incarcerated Persons

Why Early Detection Matters More in High-Risk Populations

CKD and incarceration risk factors substantially overlap

Custody status can affect medication access and administration oversight

Reentry brings acute barriers: meds, appointments, housing, transport

Early screening is cost- and outcome-effective, per Maursetter

"We have so much room to be able to impact an outcome of someone's life if we start earlier," Maursetter told 

, 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.

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. 

Laura J. Maursetter, MD, discusses why early kidney disease screening and continuity of care are especially critical for justice-involved patients.


Among chronic kidney disease (CKD) patients, incarcerated individuals have historically struggled to receive adequate kidney care.

Laura J. Maursetter, Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA, has been providing care for incarcerated persons for her entire nephrology career.

CKD Care Gaps for Incarcerated Patients, With Laura Maursetter, MD

"It has a lot of meaning for me, both in the connection with patients that I have, but also in the idea that our kidney patients in general come from socioeconomically disadvantaged groups," she told HCPLive. "This [population] is not an exception, and being able to see that we deliver care in a way that is just and good is something that I have a lot of passion for."

A Population With Few Standards and Little Oversight

While incarcerated patients with CKD are legally entitled to adequate medical care, structural problems can create barriers to access. As Maursetter points out, there is also little standardization in how that care is delivered or tracked, and the consistency of care can vary considerably depending on time served and the resources available at a given facility.

"There's not really any sort of tracking system to see what percentage of CKD patients are being seen by a nephrologist," she said. There is similarly no systematic way to confirm whether patients are receiving recommended lab work or being started on appropriate medications, she noted, making it difficult to assess what care actually looks like across the correctional system as a whole.

This absence of data is not unique to Maursetter's observations. In a paper she coauthored on kidney care in correctional settings, outcome studies in this population are described as nearly nonexistent, a gap attributed to institutional review board hurdles, the practical difficulty of recruiting and following patients who may be transferred or released, and a lack of incentive within correctional systems to track health outcomes.

Ethical concerns around research involving incarcerated people, while intended to protect a vulnerable population, have had the secondary effect of excluding that population from studies altogether, according to Maursetter. Without that data, clinicians and policymakers are left without a clear picture of how CKD affects people in custody or how well current care models are working.

The stakes of that gap are significant. Under the U.S. Constitution, incarcerated individuals retain a right to adequate medical care, a protection rooted in the Eighth Amendment's prohibition on cruel and unusual punishment and reinforced through due process protections for pretrial and civil detainees, according to a 

 published by the American Society of Nephrology (ASN). For patients with kidney failure specifically, adequate care has a narrow definition: consistent access to nephrologists and dialysis-trained nursing staff, uninterrupted dialysis or transplant medication schedules, and immediate response to complications. Disruptions to any of these, even short ones, can escalate quickly.

Building Accountability Into Correctional Nephrology

For Maursetter, closing these gaps starts with demanding basic quality standards, not just for care delivered during incarceration, but for the transition back into the community afterward.

"As a field, demanding some quality standards be implemented, demanding that care is provided so that post-incarceration people have the opportunity to be able to be taken care of in a way that is good, and we didn't miss the boat during the time that they were incarcerated, is a really important factor," she said.

That continuity concern echoes recommendations Maursetter and colleagues have made elsewhere: that nephrology teams build direct relationships with correctional healthcare staff, push for standardized CKD screening at intake, and treat the reentry period as a defined handoff rather than a point where care simply lapses.

Even the research needed to close these gaps faces obstacles, Maursetter noted. "Research is hard to do in the Department of Corrections because of the ethical questions — sometimes people just exclude that population, and then we miss the boat on being able to know more about what that population looks like."

Published online July 28, 2026. doi:10.1038/s41581-026-01108-7

People Living with Kidney Failure in Detention Facilities: Frequently Asked Questions (FAQs)

. Published March 2026. Accessed August 25, 2026. 

A nephrologist details gaps in tracking CKD screening, labs, and treatment in correctional care.