In The News

How this S.F. startup is taking on chronic kidney disease

By Hannah Norman

Carmen Peralta had spent over a decade researching kidney disease as a nephrologist, most recently at the University of California, San Francisco, when her groundbreaking work on the early detection of the deadly disease caught the attention of Cricket Health.

The startup sought her advice in its initial clinical stages, eventually offering her a job.

“I had to make a decision,” said Peralta, now the company’s chief medical officer. “Do I take this job or do I stay in academia? And it was really hard, but this was a chance to have an impact right away, and at a really big scale.”

Founded in 2015, Cricket Health works to support the estimated one in seven American adults living with chronic kidney disease (CKD). The San Francisco-based startup, which earlier this year outgrew its SoMa co-working space and moved into a newly leased office at 251 Kearny St., is swiftly ramping up its program aimed at slowing the progression of CKD, as well as supporting end-stage renal disease (ESRD) patients.

Peralta joined full-time as the company’s eighth employee in August. By the end of 2019, Cricket plans to have between 80 and 120 people on board as it rolls out the product commercially and builds multiple West Coast brick-and-mortar locations, according to Arvind Rajan, CEO of Cricket Health. The company has assisted over 200 patients on the platform, though Cricket expects that number to uptick significantly this year as well.

Using data analytics, Cricket first sifts through the patient data of its customers — insurers and healthcare systems — to identify high-risk patients, the bulk of which are asymptomatic. Caused mainly by diabetes and high blood pressure, CKD is the fastest growing noninfectious disease in the U.S., with 30 million Americans affectedand the majority don’t know they have it.

“What that translates into is one-third of patients that end up on dialysis go into the ER because they feel sick and are told it’s because they have kidney failure,” said Mike Spigler, vice president of patient services and kidney disease education at the health awareness nonprofit American Kidney Fund. “There’s no preparation.”

What’s more, dialysis is extremely expensive, costing between about $71,000 and $88,000 annually depending on the treatment type. And dating back to 1972, the U.S. Congress passed a law granting most kidney failure patients coverage by Medicare.

“What they did was they put this giant pot of gold right at the end when people are on dialysis,” said Rajan, an incentive system Cricket hopes to alter. “We can help (insurers) find the patients that will likely progress, and then we enroll them in our programs.”

Using a mix of remote, in-person and at-home care services, the program helps patients manage their CKD, slow down the progression to kidney failure and, if necessary, get prepared so that they’re not starting off dialysis in the hospital. Each patient gets a care team comprised of a nephrologist, social worker, dietician, pharmacist and nurse who take a multidisciplinary approach to tackle the problems that patients experience. They also get paired with a trained patient mentor, somebody who is further along in the disease and many times matched demographically with the patient.

“Often people are just terrified and overwhelmed,” Rajan said. “It lets a patient who has been through this before say ‘you know what, it’s not the end of the world, here’s what you can do, and by the way, this is what the surgeon’s going to be like.’ All these patients go through this with a community of other patients that are also on the same journey.”

For those patients who do start dialysis, Cricket ensures they know all their options, with the vast majority choosing home dialysis versus in-hospital, he added.

“We hope Cricket Health catches on because there’s a great unmet need for education out there,” Spigler said. “It’s much more expensive to treat a patient on dialysis than just diabetes.”

Cricket currently has two customers, one insurer and one healthcare network, though Rajan declined to share which ones. The company raised a $24 million Series A round led by Oak HC/FT in September.