Shaping the Future of Chronic Kidney Disease Management in Spain: Insights from the CARABELA-CKD Initiative

Chronic kidney disease (CKD) is a growing public health challenge in Spain, driven by population ageing and increasing risk factors. In this context, the CARABELA-CKD initiative brought together over 100 representatives from the CKD healthcare ecosystem in Spain to address this critical issue by identifying needs and improvement areas in the current management of CKD patients and proposing a comprehensive optimization of the Spanish CKD care process. This collaborative initiative involves leading scientific societies including the S.E.N. (Spanish Society of Nephrology), the SEEN (Spanish Society of Endocrinology and Nutrition), and the SECA (Spanish Society of Quality of Care), in partnership with AstraZeneca. CARABELA-CKD emphasizes data-driven decision-making and continuous quality improvement to identify and deliver innovative solutions that enhance patient care. Building on existing CKD care models, we performed an in-depth analysis of the current barriers in enhanced care and determined a series of healthcare quality indicators and areas for improvement. These areas encompass standardized protocols for care delivery, patient empowerment through education, and fostering collaboration among healthcare professionals and authorities. The CARABELA-CKD framework promotes a holistic, multidisciplinary approach, treating CKD management as a cross-functional process. As a result of this collaborative effort, a series of interventions are proposed, oriented to empower healthcare professionals to deliver personalized, high-quality care with the ultimate aim of improving patient outcomes and quality of life.