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Supportive kidney care in private practice nephrology: A quality improvement project
Meera P Suthar1, Michelle Webb2, Tara A Albrecht2
1College of Nursing, University of South Carolina, Columbia, South Carolina.
Journal of the American Association of Nurse Practitioners
|March 23, 2026
Summary
Supportive kidney care (SKC) clinics improve shared decision-making for advanced chronic kidney disease (CKD) patients. Implementing an SKC clinic in private nephrology practice increased prognosis education and advance care planning, aligning treatments with patient goals.
Area of Science:
- Nephrology
- Palliative Care
- Quality Improvement
Background:
- End-stage renal disease (ESRD) significantly impacts older adults' quality of life and survival.
- Patients with advanced chronic kidney disease (CKD) often lack understanding of treatment prognoses.
- Supportive kidney care (SKC) is underutilized in private nephrology settings.
Purpose of the Study:
- To implement and evaluate a nurse practitioner-led SKC clinic in private nephrology practice.
- To increase prognosis education and advance care planning (ACP) for advanced CKD patients.
- To improve quality of life and goal-concordant care for patients with advanced kidney disease.
Main Methods:
- A Plan-Do-Study-Act quality improvement framework was employed.
- A structured, nurse practitioner-led SKC clinic was established.
- A pre-post design assessed changes in documented education and ACP.
Main Results:
- Fifty-seven patients attended the SKC clinic.
- 98.2% of patients received documented prognosis education and completed ACP.
- Treatment preferences were clarified, with most opting for medical management without dialysis, and no hospitalizations occurred in this group.
Conclusions:
- A dedicated SKC clinic enhances shared decision-making and goal-concordant care.
- Embedding SKC in private practice empowers patients and caregivers.
- SKC facilitates treatment aligned with patient values and goals.
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