[Beyond Information: The Challenge of Innovating Communication in Nephrology, To Build Alliance and Improve Outcomes....

Introduction. Physician-patient communication is a pivotal element in the management of chronic kidney disease (CKD), yet it is sometimes reduced to a mere transmission of information. Ineffective communication undermines therapeutic adherence, delays clinical decision-making, and negatively impacts patients' quality of life. Methods. We conducted a panoramic review of the literature, with a specific focus on nephrology context, examining how various aspects (communication barriers, patient expectations, use of multimedia tools, digital self-monitoring) affect clinical outcomes and can transform from critical issues into resources for improving the therapeutic alliance and adherence. Results. Evidence shows that: (1) physician-patient communication, expectations, and genuine understanding directly influence clinical outcomes; (2) digital tools such as educational/storytelling videos, online platforms, institutional social media channels, and dedicated apps improve health literacy and patient engagement; (3) self-monitoring and smart devices can help strengthen awareness and foster the doctor-patient relationship, even remotely; (4) therapeutic adherence can be significantly improved through empathetic and shared care relationships, including through digital media, countering misinformation and mistrust. Conclusions. Innovating communication in nephrology requires moving beyond the traditional information-delivery model, embracing narrative and digital approaches, and recognizing communication as a fully-fledged therapeutic intervention.