Evaluation of a nurse-led chronic kidney disease clinic: a single-centre cohort study

The objective of this study was to evaluate the clinical outcomes and patient satisfaction of a new nurse practitioner chronic kidney disease (CKD) clinic.

This was a prospective cohort study of all patients who had their first appointment with the early CKD nurse practitioner from October 2023 to October 2024, with data extracted on 1 April 2025. The outcomes were assessed across three domains: (domain 1) change in clinical outcomes of kidney function, albuminuria and blood pressure, (domain 2) prescription of guidelines concordant medications and (domain 3) patient satisfaction with care as assessed by a survey.

There were 95 patients with a median age of 63 years [interquartile interval (IQI) 51-76], and 45.3% were female. Cardio-metabolic comorbidity was common; 82.8% of patients had hypertension, 55.6% diabetes and 25.2% cardiovascular disease. At referral the median urine albumin-creatinine ratio was 32.3 mg/mmol (IQI 11.2-53.5) and this was lower at discharge, 12.4 mg/mmol (IQI 2.9-25.3, P < .001). Systolic and diastolic blood pressure were lower at discharge [mean difference mmHg (95% confidence interval, P-value): 10.1 (6.58-13.54, <.001) and 5.2 (2.6-7.7, <.001), respectively]. There was no change in median estimated glomerular filtration rate. More patients at discharge were on a renin-angiotensin system inhibitor (88.4% versus 76.8%), sodium-glucose cotransporter 2 inhibitor (53.6% versus 28.4%), mineralocorticoid receptor antagonist (23.1% versus 5.2%) and glucagon-like peptide-1 receptor agonist (23.1% versus 9.6%). The survey response rate was 51.6% with patients reporting high satisfaction with the service.

The CKD nurse practitioner clinic was effective at implementing guideline-directed medical therapies for early CKD and associated with improvements in blood pressure and albuminuria.