Chronic kidney disease (CKD) affects an estimated one in seven American adults, with about 37 million individuals having some level of CKD and is the ninth leading cause of death. Over 40% of patients with severe renal impairment are unaware that their kidneys are impaired. According to the CDC, $81.6 billion was spent on treating Medicare beneficiaries with CKD, with an additional $49.2 billion spent treating those with end stage renal disease (ESRD).  In the United States, the two leading causes of CKD are diabetes and hypertension, which account for 67% of ESRD cases.