Enhancing CKD Early Detection in High-Risk Populations Via Community Programs, AI, With Salvatore Viscomi, MD

In communities with increased levels of disadvantage, the asymptomatic nature of chronic kidney disease (CKD) poses a substantial risk.

To combat the lack of awareness surrounding CKD and its symptoms, Salvatore Viscomi, MD, Founder and Chief Executive Officer of Carna Health, suggests implementing Artificial Intelligence (AI) tools and community centers to enhance the availability of data for these populations.

"Education and awareness at the community level are critically important. Bringing diagnostics and testing into the community is essential, especially given the challenges people face — having to leave their homes, leave their jobs, and manage their family responsibilities," said Viscomi in an interview with HCPLive. "For many, it's simply not an option to just go in for a wellness check, even if they're aware of a family history. So for us, it's been really important to be present in the community, find community champions, and to start there: start with education and awareness."

In the US, > 90% of people with early-stage kidney disease are unaware of their condition. As Viscomi notes, many patients remain asymptomatic and are not seeking routine wellness checks, and for those in disadvantaged communities, the barriers to doing so are compounded by competing daily responsibilities. Early-stage CKD is often described clinically as a "silent disease," making community-level outreach all the more essential. Viscomi also points to an often-overlooked factor, a deep-seated mistrust of the healthcare system that keeps many from engaging with conventional care at all.

The logistical burden of seeking care is more significant than many realize. A study conducted by a colleague of Viscomi's in the UK found that a routine blood and urine test for kidney disease required a five-hour round trip from home, and that was by car. For those relying on public transportation, the burden is even greater. Combined with the cost of missed work, childcare, and transportation, routine monitoring becomes prohibitive for many patients.

Access to specialists compounds the problem further. In many parts of the United States and around the world, nephrologists are scarce, making specialist care effectively out of reach for large portions of the population most at risk.

Diet and clean water present additional, deeply structural challenges. In many communities, healthy food is simply not affordable. Ffresh fruit and vegetables can cost significantly more than processed, calorie-dense alternatives. Clean water access is also a concern, particularly for outdoor workers in low- to middle-income countries, who may face a choice between water contaminated with pesticides and kidney-damaging toxins, or sugary high-fructose drinks. Viscomi links this directly to a rising incidence of CKD among young outdoor workers globally.

Data has emerged as a potential bridge between underserved populations and recent breakthroughs in kidney disease care, but only if that data reflects the communities most affected.

"Digital health tools, for example, could potentially benefit those who can afford them or have access to them," said Viscomi. "If you think about AI predictive analytics, which can be fantastic, there's a real problem if data is only being collected from populations that already have access to plenty of care, the populations not being included won't benefit from understanding their risk progression."

The same risk extends to emerging medications and self-testing technologies. GLP-1 medications, which carry both anti-inflammatory and renal protective properties, remain unaffordable or unavailable in most of the world.

Self-testing, widely seen as the future of healthcare, will likely reach disadvantaged populations last due to cost. Viscomi argues that this is shortsighted: the burden of disease is ultimately shared by everyone, making broad investment in accessible self-testing not just an equity issue, but an economic one.

For Viscomi, the solution begins with a fundamental shift in how care is delivered. Rather than expecting patients to navigate the barriers of transportation, cost, and specialist access, the model needs to go to them, through mobile units on farms, testing at local pharmacies, and screening programs at places of worship such as churches and mosques.

Editor’s Note: Viscomi reports relevant disclosures with Carna Health, Dama Health, QuantaBrain, and others.

References

1. Lundin A. Digital Health Platform Leverages AI and POC Testing for Improved CKD Diagnosis. Clinical Lab Products. Published February 4, 2025. Accessed March 10, 2026. https://clpmag.com/disease-states/kidney-disease/digital-health-platform-leverages-ai-and-poc-testing-for-improved-ckd-diagnosis/

2. Vassalotti JA, Diamantidis CJ, Cook DJ. Shared Viewpoint—Developing the Future of Kidney Care. Journal of General Internal Medicine. 2021;37(4):947-948. doi:https://doi.org/10.1007/s11606-021-07014-x

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