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Ziva Health›Solutions›Nephrology
For nephrology practices

Fluid retention
shows up on the scale first.
If someone is watching.

Weight climbs, blood pressure creeps up, swelling worsens - days before a patient calls. Ziva watches every enrolled CKD patient daily and escalates the pattern to your team while it's still manageable in clinic.

HIPAA compliant · Connected scales & cuffs · CKD stage 3–5, pre-dialysis monitoring · RPM & CCM eligible

Book a demo How Ziva helps →
CKD cohort · this morning
Evelyn R., 68* · CKD Stage 4
+4 lb / 4 days · ankle swelling reported
Escalate
Marcus T., 59* · CKD Stage 3
Home BP 148/92 avg, 10-day trend
Watch
Carol B., 72* · CKD Stage 3
Weight & BP stable · meds on schedule
Stable
Isabella
"Evelyn has gained 4 pounds in 4 days with new ankle swelling reported this morning. Rapid weight gain plus new edema is a classic fluid-overload pattern in CKD — flagged for same-day review."
*Stories are inspired by real patient experiences and health patterns observed in care. Names, images, quotes, and certain details have been changed or combined to protect privacy. Individual experiences and outcomes may vary.
The gap

The data you need arrives
after the progression.

CKD progression and fluid status are measurable daily - weight, blood pressure, swelling - and most nephrology panels are still managed on quarterly labs and visits.

Fluid overload
Weight gain and swelling are measurable days before symptoms force a call. Without daily weights reaching your team, that window is spent unmonitored.
Uncontrolled hypertension
Blood pressure control is the single biggest lever on CKD progression, yet office readings are infrequent and noisy.
Medication adherence
Phosphate binders, diuretics, and antihypertensives all depend on daily adherence that is invisible between visits.
The continuous care experience

A daily renal
record for every patient.

Each CKD patient has a daily point of contact and a daily data record. Isabella handles the routine; your team sees the deviations.

01
Morning weight and BP
Connected scale and cuff transmit automatically. Standardised timing, no manual logging.
02
Symptom check-in
Swelling, fatigue, appetite, and urine output changes captured daily in plain language.
03
Isabella correlates
Weight trajectory against BP against symptoms - the sequence, not just the values.
04
Coaching between visits
Sodium, fluid intake, and medication timing reinforced daily.
05
Escalation with the sequence
Your team gets the trend, symptoms, and adherence history together, ready for a same-day review.
How Ziva helps

What Ziva does
for a nephrology practice.

Objective daily physiology plus subjective daily symptoms plus adherence - the three inputs that determine whether CKD progression is caught early.

CKD
Weight & fluid monitoring
Daily weight trended against dry weight, escalated on trajectory rather than a single threshold.
Hypertension
Home BP averages
Titration decisions based on a rolling home average rather than an infrequent office reading.
Symptoms
Edema & fatigue tracking
Swelling and energy levels tracked daily so decline is a curve, not a surprise.
Adherence
Medication adherence
Phosphate binders, diuretics, and antihypertensives tracked separately by clinical relevance.
Labs
Lab result integration
eGFR, potassium, and creatinine trends layered alongside daily vitals on one timeline.
Pre-dialysis
Pre-dialysis coaching
Patients approaching dialysis get daily reinforcement on diet, fluid, and access-site care.
Impact

Outcomes that matter
in renal care.

Earlier detection changes the setting of care - clinic instead of emergency department, titration instead of admission.

Earlier
Fluid overload detection
Weight trajectory and symptom clustering flagged days before a call
Daily
BP and weight data
Home averages guide titration instead of a single office reading
Proactive
Adherence tracking
Phosphate binder and antihypertensive adherence tracked by drug
Illustrative
Program revenue
Modeled RPM/CCM revenue for your panel - see reimbursement below

Directional framing based on Ziva's platform capabilities; actual results depend on panel size and payer mix.

Proof

Four days of rising weight,
caught before the ER.

Conditions covered

Renal and comorbid conditions.

CKD patients typically carry hypertension and diabetes. Ziva runs concurrent protocols on the same record.

Chronic kidney diseaseHypertensionDiabetesWeightHeart failureAll conditions →
Reimbursement

Nephrology fits
RPM and CCM well.

Device-based physiologic monitoring is squarely what RPM was written for, and most CKD patients also meet CCM’s two-chronic-condition requirement.

RPM — 99453 / 99454 / 99457 / 99458
Device-based physiologic monitoring, 16+ transmission days per month
99453One-time setup & patient education — ~$19
99454Device supply + daily transmission — ~$46/mo
99457First 20 min interactive care management — ~$48
99458Each additional 20 min — ~$39
CCM — 99490 / 99439
Patients with two or more chronic conditions expected to last 12+ months
99490First 20 min clinical staff time / month — ~$62
99439Each additional 20 min — ~$47 (up to 2×)
Ziva's time logs, monitoring records and monthly reports supply the documentation these codes require. Confirm eligibility and rates with your billing team and MAC.
Program revenue estimate
Enrolled CKD patients 110
10typical enrollment ramp500
Program type
Device supply (99454)—
First 20 min (99457)—
Additional 20 min (99458)—
Estimated monthly program revenue
—
— annually
Illustrative national-average estimates. Actual reimbursement varies by MAC, locality, payer mix and documented time.
Self-pay option
Not billing insurance? Charge patients directly.
Set your own price for a monthly monitoring program, membership or package. Connect your payment system to Ziva and get paid directly, alongside or instead of CPT billing.
Connects with
StripeSquarePayPalYour existing system
See plans →
Get Started

Start with your
CKD Stage 3–4 cohort.

Most nephrology practices begin with their Stage 3–4 panel, where slowing progression toward dialysis has the clearest impact, then expand from there.

✓Cohort selection and eligibility analysis
✓Alert threshold design for your clinical protocols
✓Revenue modelling for your panel
✓Live in 4–6 weeks including device logistics
Request a 30-minute demo
We'll walk through enrolment, alert configuration, and the revenue model for your practice.
Book my demo →
No commitment. We'll follow up within 1–2 business days.
Security & compliance

Built for healthcare.
Trusted by clinical teams.

Ziva was designed from the ground up for clinical environments - not adapted from a consumer app. Every data flow, access control, and integration meets the standards your compliance team requires.

🔒
HIPAA compliant
BAA available. All PHI encrypted in transit and at rest.
✅
End-to-end encrypted
HL7 FHIR R4 compliant data exchange.
🏥
US data residency
All patient data stored and processed within the United States.
📋
Audit-ready logs
Consent records, access logs, and billing documentation stored and exportable.
Questions

Nephrology FAQ