Part 01 · The Problem

The kidneys speak late

Kidneys give almost no symptoms until 90% of their function is gone, so most people are diagnosed late. The real difficulty, though, begins after diagnosis.

The Doubling

2× in ten years — 347,000 CKD patients treated in Korea

Patients are increasing, and the causes sit outside the kidney: the dinner table changed, metabolic disease rose, and the population aged.

346,518
CKD patients treated (2024)
2.03× the 170,576 of 2015
NHIS · Oct 2025
6.3%
Adult prevalence (age-standardized, 2024)
25.9% among those 70+
PHWR 2025
137,705
On kidney replacement therapy (2023)
18,052 new · 59% aged 65+
KSN KHP 2033
2,608pmp
ESKD prevalence
per million population · 3rd worldwide
Korean Society of Nephrology
Food environment

Food delivery ×10.8

₩2.7T → ₩29.3T (2017 → 2024). "We cook at home" fell from 93.0% to 60.4%. Ultra-processed food rose from 17.4% to 25.3% of energy intake.

Metabolic disease

5.33M with diabetes

14.8% of adults 30+ (2022). About 14.1M in prediabetes. Obesity among men in their 40s: 61.7% (2024).

Demographics

20.3% aged 65+

Korea became a super-aged society in 2025. CKD prevalence at 70+ (25.9%) is about four times the adult average.

Primary causes of end-stage kidney disease in Korea

KSN registry 2023 · n = 137,705

Diabetes45.9%
Hypertension22.2%
Glomerulonephritis10.5%
Other21.4%

Diabetes and hypertension alone account for 68%. Kidney disease does not start in the kidney.

We do not claim causation. Observational studies report a 1.25× CKD risk in the highest ultra-processed-food group (meta-analysis of 4 cohorts) and 1.51× proteinuria risk with obesity. Only the registry's cause shares are measured values.

The Cost Cliff

The cost cliff — ₩100K for early care, ₩28M for dialysis

The economics of kidney care come down to one comparison.

Annual cost per CKD patient · drawn to scale

Early-stage care≈ ₩100K
Peritoneal dialysis₩19.4M
Hemodialysis₩27.4M

The top bar being almost invisible is the accurate picture. Delaying one patient's dialysis by one year avoids roughly ₩27M in that year alone.

₩2.83T
Total CKD treatment cost (2024)
3rd-largest single diagnosis
Projected ₩5–6T by 2033
84%
of treatment is hemodialysis
Transplant 11% · Peritoneal 6%
2022
49.8%
Leading cause: diabetic nephropathy
Glucose control is kidney care
Korea

This is the logic that built companies in the U.S. Strive Health raised a $550M Series D (Sept 2025), Somatus $325M, Monogram Health $375M from CVS, Cigna and Humana, and Interwell Health was valued at $2.4B in its three-way merger. None of them charge patients. They share savings with payers.

The Awareness Gap

The awareness gap — 87% don't know

One in seven U.S. adults has chronic kidney disease, and most don't know it. Korea has no official awareness statistic at all.

788M
Adults with CKD worldwide
Age-standardized prevalence 14.2%
GBD 2023 · The Lancet, Nov 2025
37M
U.S. adults with CKD
14% of adults
CDC, Mar 2026
87%
Unaware of their CKD
Adults 20+
CDC, Mar 2026
$77B
Medicare CKD spending, beneficiaries 66+
24.1% of total · ESRD another $52.3B
USRDS 2023 ADR

Asian Americans are especially exposed: 23% of South Asian, 22% of Southeast Asian, and 14% of East Asian adults have diabetes (JAMA 2019), and 26% of Asian Americans with hypertension also have CKD — the highest share of any group. That is why the first U.S. beachhead is the Asian-American community.

The Empty Middle

The empty middle — no commercial player in kidney

Korea's chronic-disease app market is crowded around diabetes.

Commercial app operators by condition, Korea

VC-backed or with disclosed revenue · surveyed Aug 2026

Diabetes3
Cardiac1
Insomnia1
Kidney0

Diabetes: Dr.Diary, Kakao Healthcare, Huray Positive. Kidney: only the nephrology society's free public app "Heidi" (2019).

Why the gap exists

No sensor, so nobody built it

Diabetes has continuous glucose monitors that feed data automatically, and enough patients for B2C scale. Kidney disease has no such sensor; the data arrives once every three months, from the hospital. So patients still write on paper.

The contest is not about sensors. It is about designing something patients will log into every day — behavioral design and brand, which is where we are strong.

The U.S. is not empty — it is immature

Patient pays

D2C apps

CKD Tracker · KidneyPal · KidneyDiet. Lab logging and "a PDF for your doctor" already exist, but they are diet-centric or early-stage.

Provider pays

Dialysis-provider apps

myDaVita · Fresenius PatientHub. Free but closed to their own patients. Pre-dialysis patients are out of scope by design.

Payer pays

Value-based kidney care

Interwell · Somatus · Strive · Monogram. Deep pockets, but they cover only contracted members and source engagement tech through acquisition or partnership.

The gap we aim at — pre-dialysis CKD stage 3–4. Blind spot of the dialysis apps, outside the payer contracts, and only lightly served by D2C. No dominant player has yet built on the axis of "lab log + trend + pre-visit report."
Why Now

Policy is starting to move toward the kidney

Apr 2026

6th National Health Plan (2026–2030)

CKD included as a standalone priority for the first time. The Korean Society of Nephrology is pushing a CKD Management Act.

Jan 2025 / Jan 2026

Digital Medical Products Act · self-declaration scheme

A registration and performance-certification track for digital health-support devices opened, giving wellness products a door into the system.

Next in line

Primary-care chronic disease program

Still covers only hypertension and diabetes. The moment CKD is added, demand for patient-management tools becomes institutional.

Feb 2026 / Jan 2026

MFDS and FDA guidance revised

Korea's wellness criteria and the FDA's General Wellness and CDS guidance were both revised in a loosening direction.

Sources · NHIS (analysis via Rep. Choi Bo-yoon's office, Oct 2025) · KSN KHP 2033 policy proposal (Apr 2025) · PHWR 2025 · GBD 2023, The Lancet (Nov 2025) · CDC CKD Fact Sheet (Mar 2026) · USRDS 2023 ADR · JAMA 2019 · Scientific Reports 2025 · Renal Failure 2024 · Kidney International 2017 · MedCity News, Fierce Healthcare (2025). Dialysis counts and prevalence differ by source definition (age-standardized vs. crude; registry vs. claims); reference year and source are given for each figure.