Patients with chronic kidney disease often face complex health care decisions, including identifying their need for palliative care.

Few kidney patients have advance care plans, despite the need for crucial choices like the continuation of dialysis, according to a 2021 study published in the Journal of the American Society of Nephrology. Early advance care planning is “especially important” for this population, the study indicated.

“Chronic kidney disease is a patient population that needs a lot of support. In advance care planning, the presumption is that it’s something that’s done only towards the end of life, but advance care planning is just the act of planning your care in advance, and we realize that that can be applicable to a lot of different scenarios,” Koda Health CEO Tatiana Fofanova told Palliative Care News. “By going upstream, we’re able to help patients get access to higher quality care that’s aligned with their goals, values and the quality of life preferences many years before they approach that end-of-life event.”

Fofanova co-founded Koda Health in 2020 with the company’s CMO Dr. Desh Mohan and Katelin Cherry, the company’s chief technology officer. The three met and began collaborating at the Texas Medical Center’s (TMCi) Biodesign program, which tasked them with finding solutions to problems affecting the health system. Koda Health spun out of that work as an independent company.

The company’s platform is designed to digitize patients’ decision-making around their care preferences and goals. Koda in February 2022 secured $3.5 million in growth capital to spur the expansion of its platform and hire additional staff. A second funding round took place this year. Though the dollar amount of the newest round is confidential, the total investment was in the “same ballpark,” Fofanova said.

Koda Health recently launched a series of partnerships with hospice providers using a model designed specifically for helping facilitate advance care planning and education for kidney patients.

Chronic kidney disease patients can face serious risks that can seriously impact their quality of life. The dialysis issue is among the most important plans to make. Patients receiving dialysis are more than twice as likely to die in the intensive care unit, commonly countering patient preferences to die at home, the 2021 study found.

The research also indicated that adjusted mortality among dialysis patients younger than 75 is four-fold higher than age-matched nondialysis Medicare beneficiaries.

Many of these patients can benefit from access to palliative care, including advance care planning, according to the National Kidney Foundation.

“It’s providing better care for the patient, more aligned care for the patient, and the data shows that when we’re able to do that, it’s also reducing total cost of care as well,” Mohan told Palliative Care News. “They’re more likely to start outside of the hospital in the outpatient setting, and they’re more likely to have an opportunity to identify the modalities that work best for them.”