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Laura J. Maursetter, MD, discusses the case for standardized kidney screening protocols, transplant access, and medical education reform for the correctional population.
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.
Why a Single Visit Still Matters
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."
Key Facts
The Case for Standardized Screening
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.
A Small Field, a Wide Gap in Advocacy
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.
