Caring for Adolescents and Young Adults With Kidney Disease: Nephrologist Education

Adolescents and young adults with chronic kidney disease experience adverse outcomes at unacceptably high rates, and the knowledge and experience of adult nephrologists in caring for young patients and patients with congenital kidney disease is a contributing factor to these adverse outcomes. Here, we compare adult and pediatric nephrologists' practices in transitioning patients from pediatric to adult care and evaluate adult nephrologists' self-reported educational needs.

An anonymous, online survey conducted from January 30, 2024, to May 7, 2024.

Practicing US nephrologists (adult and pediatric) completed the survey.

Descriptive statistics were conducted for all survey variables, n (%).

One hundred thirty-three adult nephrologists and 22 pediatric nephrologists completed the survey demographics. About 71% of adult nephrology respondents were unfamiliar with the American Academy of Pediatrics 6 core elements (vs 17% of pediatric nephrologists), and 63% were unfamiliar with the International Society of Nephrology/International Pediatric Nephrology Association consensus statement on transitioning patients from pediatric to adult nephrology care (versus 26%). In addition, adult nephrologists report they are not familiar or slightly familiar with youth health/adolescent medicine (68%), childhood/congenital causes of kidney disease (27%), and medications approved for patient < 18 with kidney disease (51%). 48% of adult nephrologists had not received training in health care transitions. About 91% of adult nephrologists felt that further training in health care transitions would be useful or somewhat useful and felt it should be included in residency training (37%), fellowship training (96%), and after completion of formal training (37%).

The survey was modeled on previously published instruments but not validated. The survey was also susceptible to respondent bias.

Of the responses collected in this survey, most adult nephrologists are unaware of health care transition guidelines and unfamiliar with caring for young patients with chronic kidney disease. The creation of a health care transitions curricula that addresses these topics is imperative.