Patient Perceptions Support Co-Management of Chronic Kidney Disease

Approximately 35.5 million adults are living with chronic kidney disease (CKD), affecting 1 in 7 in the US.¹ Progression of the disease can lead to end-stage renal disease (ESRD) and kidney failure. Patients with CKD can benefit from specialized care from a nephrologist and additional education.

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Researchers from the Kidney Coordinated HeAlth Management Partnership (Kidney CHAMP) trial assessed an electronic health record–based population health management intervention to improve care in patients with CKD without a nephrologist and who were at high risk of ESRD.² The intervention included nephrology guidance to patients’ primary care providers (PCPs), pharmacist-led medication management, and patient education about CKD. Pharmacists contacted patients and assessed their vaccination status, medication regimen, and OTC medication use and provided recommendations on medications to avoid.²

Pharmacists then completed a standardized template identifying any concerns and recommendations and discussed these with the PCPs and nephrologists 2 to 4 times per week and implemented recommendations mutually decided. To further understand the effectiveness of the Kidney CHAMP intervention, these researchers conducted a qualitative research study to assess the perceptions of patients who attended at least one CKD education session.³

A total of 45 patients were enrolled in the study with a mean age of 75, predominantly white males, and a mean estimated glomerular filtration rate of 37 mL/min. Patients were interviewed via televideo or telephone. Nurse educators provided information about CKD diagnosis and stages, risk factors, and the importance of controlling comorbidities such as hypertension and diabetes. Nurses also delivered information on diet, physical activity, and the complications and treatments related to CKD, including dialysis and kidney transplant. Nurses provided additional counseling on the importance of medication adherence and OTC medications that should be avoided. These sessions occurred every 4 to 6 months.³

After the sessions, researchers conducted interviews that focused on patient understanding of the information provided to them during the education sessions. The information included signs and symptoms of CKD, effects on their health, and their interactions with the nurses and their physician, including the PCP–nephrologist electronic consult.

The researchers identified 4 specific themes regarding the results of the trial³:

• Patient support of collaborative co-management
• Education sessions and patient understanding of CKD and health implications
• Self-efficacy and understanding of CKD among patients
• Perception and acceptance of education sessions

Patients were supportive of co-management support from their nephrologist to their PCP and appreciated the referral to a nephrologist with worsening CKD. The patient education sessions varied in improving patient understanding of CKD and health implications. Some patients reported that CKD was a low priority because they were not experiencing symptoms. Additionally, approximately one-third of patients reported a limited understanding of CKD, and many did not believe that it affected their health.³

For the management of CKD, most patients were able to provide information about dietary advice, such as drinking more water and minimizing salt intake. Some reported long-term effects of CKD and interest in learning more self-management skills to prevent worsening of kidney function.

Lastly, the education sessions were well accepted by most patients, and they said they would recommend the sessions to other patients. To improve the sessions, patients suggested that information be more individualized and provided in plain, understandable language.

Key Takeaways

Based on the findings of this study, it is important to provide education to patients with CKD. Although pharmacists were actively involved in medication management services in the Kidney-CHAMP trial, this trial did not assess patient perceptions of the pharmacist’s interaction. This could be because the pharmacist–patient interactions were minimal. Pharmacists involved in a multidisciplinary team with nurses and doctors can improve the care of patients with CKD.

In a community practice, pharmacists can actively be involved by counseling patients about the signs, symptoms, and management of CKD. Counseling on the importance of medication adherence and avoiding nephrotoxic OTC medications such as non-steroidal anti-inflammatory drugs to help minimize kidney decline and promote patient–pharmacist interactions is also important.

REFERENCES

1. Kidney Disease Statistics for the United States. National Institute of Diabetes and Digestive and Kidney Diseases. Updated September 2024. Accessed August 14, 2025. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease

2. Jhamb M, Weltman MR, Yabes JG, et al. Electronic health record based population health management to optimize care in CKD: design of the Kidney Coordinated HeAlth Management Partnership (K-CHAMP) trial. Contemp Clin Trials. 2023;131:107269. doi:10.1016/j.cct.2023.107269

3. Lavenburg LMU, Devaraj SM, Gul A, et al. Patient perceptions of a population health management program to improve kidney care: optimizing care in CKD. Kidney Med. 2025;7(7):101025. doi:10.1016/j.xkme.2025.101025