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Kidney Week

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Abstract: FR-PO418

Pediatric to Adult Nephrology Transition Program: The Northwestern Experience

Session Information

  • Pediatric Nephrology - I
    November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1800 Pediatric Nephrology

Authors

  • Kang, Jay Hyun, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Nishi, Laura, Northwestern Medicine, Chicago, Illinois, United States
  • Ghossein, Cybele, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Group or Team Name

  • Northwestern Nephrology
Background

Young adults (YA) with chronic kidney disease (CKD) transitioning care from pediatric to adult medical facilities face many obstacles. Six years ago, the Nephrology division at Northwestern Medicine (NM) implemented a transition program for YA with CKD. The initial transfer visit was led by an adult nephrology team in the pediatric nephrology space at Lurie Children’s Hospital. Follow up care then occurred in the adult nephrology clinic at NM. Here we report on our outcomes.

Methods

All patients that were seen in transition clinic between 2016-2021 were included. Successful transfer of care was defined as a completed transition clinic appointment. Successful transition was defined as one or more completed appointments in the NM adult nephrology clinic. An enhanced communication protocol of phone calls, texts, and emails from the adult nephrology team would be triggered for any patients who failed to show up for their follow up appointment.

Results

There were 141 patients who completed their transfer visits. 67 (47%) were female and 74 (53%) were male, with the most common diagnoses being congenital kidney disease (30%) and glomerular disease (24%). 82 patients (58%) were insured with private insurance, 54 (38%) with government insurance, and 5 (4%) had no insurance. Five patients were discharged from nephrology care at the initial transition clinic appointment. Six patients transitioned to external nephrology providers. Successful transition initially occurred in 93 patients (74%) with 32 (26%) patients missing their follow up appointment. Sixteen patients (13%) subsequently successfully transitioned after the enhanced communication protocol was activated, increasing our successful transition rate to 87%. Sixteen patients (13%) were lost to follow up.

Conclusion

Based on our experience, successful pediatric to adult transition can be achieved with a dedicated transition program. Enhanced communication protocols for those missing their first adult nephrology clinic appointment can improve successful transition.