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September 5, 2026Clinical Journal of the American Society of Nephrology

A Randomized Pilot Trial of a Nephrologist Communication Tool for Discussing Conservative Management

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Authors

SWSusan WongOGOlivia GaughranDPDavid K. Prince

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Overview

Randomized trial reveals improved discussion rates and patient satisfaction in older adults with advanced chronic kidney disease, highlighting the utility of structured communication tools.

Key Points

  • To assess the feasibility and acceptability of a clinician communication tool designed to help nephrologists discuss conservative kidney management with older patients with advanced chronic kidney disease.
  • Randomized pilot trial enrolling 74 patients aged ≥75 years with stage 4 or 5 chronic kidney disease in the greater Seattle area between April 2023 and May 2025.
  • Patients were randomized 1:1 to either their nephrologist receiving the Conservative Kidney Management Jumpstart Tool prior to their next appointment (intervention, n=37) or usual care (control, n=37).
  • Evaluated the primary outcome of patient-reported discussion of conservative management via intent-to-treat chi-square analysis and pre-to-post visit changes on the Quality of Communication Scale using paired t-tests.
  • Patients in the intervention arm were significantly more likely to report discussing conservative management during their clinic visit than those in the control arm (60% vs. 19%, p=0.001).
  • Patients whose clinicians received the tool showed significant improvements in perceived clinician communication scores from pre- to post-visit (7.5±2.1 to 9.0±1.7, p<0.001), whereas scores in the control group remained unchanged (7.8±1.9 to 7.9±1.8, p=0.54).

Cite This Study

Wong et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd49d6b95aff0620ec5f6https://doi.org/10.2215/cjn.0000001213
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Provider Knowledge, Attitudes, and Practices Surrounding Conservative Management for Patients with Advanced CKD2016 · 52 citations
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  4. 4Exploring the acceptability of a community-enhanced intervention to improve decision support partnership between patients with chronic kidney disease and their family caregivers2024 · 3 citations
  5. 5Usability Testing of the Kidney Score Platform to Enhance Communication About Kidney Disease in Primary Care Settings: Qualitative Think-Aloud Study2022 · 49 citations