PR Renal Health & Research (PR Renal, Renal Health) is a clinical service and research organization registered in 2009 by Dr. Otegbola Ojo and Dr. Rafael Burgos Calderon to provide comprehensive integrated and cost-effective care for chronic kidney disease (CKD) and its key causes and complications in Puerto Rico (PR). The founding nephrologists have between them extensive health care delivery experience including developing new medical services, crafting public policy recommendations and managing healthcare institutions in Canada and Puerto Rico. PR Renal provides an integrated multidisciplinary program for early detection and care for kidney disease and key co-morbid conditions such as hypertension, diabetes, and other metabolic and cardiovascular complications. The program is a systematic protocol driven care process using the clinical guidelines established by the National Kidney Foundation. This program replaces the typical reactive treatment of CKD with a promotion and preventive renal health model designed to retard the progression of kidney disease, reduce the incidence rate of ESRD and improve the quality of life of patients through engagement in self-care and adherence to care plan. The program achieves its goals working with patients and their family members to create individual Care Plans using our proprietary software tool. We employ a full service electronic health care management system on a secure private computer network. Our program has delivered significant clinical outcome improvements and cost reductions through the reduction of ER visits and patient bed-days while establishing the idea of co-localization and integration of services to reduce unnecessary utilization of services. The program, as the first of its kind in Puerto Rico, has assembled the services of nephrologists, internists, nutritionists, social workers and renal nurses with the support from other specialties such as endocrinology, cardiology and radiology provided in the same clinic. We currently operate 6 CKD clinics throughout the island and planning on opening additional sites to facilitate access to our services.