The Interdisciplinary Clinic for Chronic Kidney Disease

The chronic kidney disease (CKD) clinic has emerged as an interdisciplinary care (IDC) model that encompasses patient education, medical management of CKD complications and CKD risk factors, and quality improvement. The CKD clinic team may include physicians, advanced practice providers, nurses, dieticians, pharmacists, and social workers. Team structure and clinic goals should be tailored to local practice needs. Common goals include CKD education, renal replacement therapy (RRT) planning, and treatment of complications of CKD based on national/international guidelines. Data suggest that CKD clinics slow CKD progression, improve CKD and RRT education, and lead to greater rates of home dialysis and permanent access placement. Financing of CKD clinics remains problematic as many insurers do not pay for IDC services. The long-term viability of the CKD clinic model may ultimately depend on demonstrating effectiveness and a reduction in overall patient care costs.