Repositioning the Canadian CKD Clinic Network Through Structured Input and World Café Dialogue: A Conference Report

This conference report describes findings from activities to reposition the Canadian Chronic Kidney Disease (CKD) Clinic Network by identifying research priorities and actionable steps aligned with the 2024 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The initiative aimed to identify priority actions to integrate clinical research and care through collaborative dialogue and community-driven planning.

The 2024 KDIGO Clinical Practice Guideline for CKD served as the foundation to assess and prioritize relevant research areas. Insights were gathered through a national survey and a participatory workshop using World Café methodology.

An anonymized online semi-structured survey was distributed to members of the Canadian CKD Clinic Network from April 4-14, 2025 to assess the perceived relevance and importance of the 2024 KDIGO CKD guideline research recommendations. This was followed by an in-person World Café workshop in May 2025 involving patients, clinicians, researchers, and administrators. Data collection included live graphic recording, table notes, and Post-it reflections, which were thematically analyzed.

The survey yielded responses from 80 network members, representing a 24% response rate. Survey results prioritized the need for research on: the impact of newer medications (SGLT2i, non-steroidal mineralocorticoid receptor antagonists) in patients intolerant of ACEi/ARB, implementation science to ensure uptake of proven therapies and symptom management, essential components for transition clinics for young people, tools for health literacy in different populations, strategies to prevent hyperkalemia, impact of medication deprescribing, effects of dietary restriction, and symptom identification, classification, and control. Attendees of the World Café (n=19) identified several network strengths, including its established relationships that drive national collaboration, willingness in knowledge sharing, and inclusion of the patient voice. Feedback emphasized the need for collaborative implementation and context-sensitive application of guidelines. The workshop also aligned the network's future direction with Learning Health System principles, which embed research into routine care delivery, supporting goals with provincial and national CKD strategies, deepening patient engagement, shared measurement tools, and local-to-national learning loops. Actionable steps identified included enhancing visibility through a public-facing website, anchoring activities to sustainable national platforms, and exploring additional partnerships and collaborative research opportunities.

Only 24% of the CKD Clinic Network responded to the survey, and 19 members were present at the World Café, reflecting perspectives from only a small portion of the network. Therefore, the results may overlook key challenges or opportunities that did not surface due to missing perspectives of others within the kidney care community.

This initiative demonstrates how engaging diverse perspectives can inform network transformation and future strategic research directions. The CKD Clinic Network is well-positioned to evolve into a responsive, patient-centred platform that drives learning and improvement in health care delivery across Canada's kidney care system.