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Multidisciplinary Chronic Kidney Disease Clinic Practices: A Scoping Review.

David Collister^1,2, Lonnie Pyne¹, Jessie Cunningham²

¹St. Joseph's Healthcare Hamilton, ON, Canada.

Canadian Journal of Kidney Health and Disease

|November 1, 2019

Summary

Multidisciplinary chronic kidney disease (CKD) clinics show varied designs and practices globally. Further research is essential to establish optimal models for CKD care delivery and patient outcomes.

Keywords:

CKD multidisciplinary scoping review

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Area of Science:

Nephrology
Public Health
Healthcare Management

Background:

Multidisciplinary chronic kidney disease (CKD) clinics are recognized for improving patient outcomes.
However, the optimal design and operational structure of these clinics remain unclear.

Purpose of the Study:

To conduct a scoping review to identify and describe current practices in multidisciplinary CKD clinics.
This includes examining clinic structure, function, team composition, entry criteria, and follow-up protocols.

Main Methods:

A systematic literature search was performed across multiple databases (Medline, EMBASE, Cochrane, CINAHL).
Included studies were randomized controlled trials, non-randomized interventional studies, or observational studies of multidisciplinary CKD clinics published from 2002 to present.
Data abstraction focused on team composition, entry criteria, follow-up frequency, and reported processes.

Main Results:

The review included 40 studies involving 23,230 patients across 12 countries.
Common team members included nephrologists, nurses, and dietitians, but roles and standardized procedures were infrequently reported.
Significant heterogeneity was observed in clinic composition, entry criteria (GFR 20-70 mL/min/1.73m²), and follow-up frequency.

Conclusions:

There is considerable heterogeneity in the multidisciplinary approach to CKD care, with inconsistent reporting of intervention details.
Current studies are limited by a lack of standardized definitions and geographical representation.
Further research is needed to determine the most effective models for multidisciplinary CKD clinics.