ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: FR-PO0732

Patient-Reported Ratings of Pediatric to Adult Nephrology Transition in Young Adults with CKD

Session Information

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Grzesek, Kimberly, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, United States
  • Richardson, Kelsey L., Oregon Health & Science University, Portland, Oregon, United States
  • Pruette, Cozumel S., The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Johnson, Rebecca J., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Matheson, Matthew, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Hooper, Stephen R., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Background

Effective healthcare transitions are crucial for long-term health outcomes in young adults with chronic kidney disease (CKD). Without a successful pediatric to adult transition, individuals risk poor outcomes. While formal transition programs are growing, their impact remains hard to quantify. Patient reported outcomes are an important tool to understand patient experience but are underused in CKD transition evaluation. To address this gap, we utilized the Chronic Kidney Disease in Children (CKiD) study to describe patient reported pediatric to adult health care transition outcomes.

Methods

Participants enrolled in CKiD who had transitioned to adult care answered, “How would (participant) rate the overall transition to adult care?” Participants rated their transition on a 1 (poor/hard) to 5 (great/easy) Likert scale. Ratings of 4-5 were categorized as “good,” and ratings of 1-3 were categorized as “poor.” Logistic regression was used to estimate odds of poor transition. The model included a curated set of a priori predictors: age, sex, household income, dialysis/transplant, executive functioning (EF), and overall quality of life (QOL).

Results

From 2017 to 2024, 110 participants rated transition. The median age at time of transition rating was 22.7 years [IQR 20.8 – 25.0]. The transition was rated as good by 79 participants (72%) and as poor by 31 (28%). Poor transition ratings were more likely among females, OR=3.6 (95% CI 1.3, 9.9), p<.01, highlighting potential sex disparities in transition experiences. Importantly, maternal education, eGFR, dialysis/transplant, IQ, and EF were not associated with poor transition. Lower health-related QOL was significantly associated with poor transition rating, OR=0.67 (95% CI 0.47, 0.97), p<.03.

Conclusion

This study provides initial insight into how young adults with CKD perceive transition to adult care, raising the potential importance of sex and quality of life in the transition process. While clear modifiable predictors were not identified, these preliminary findings lay the foundation for examining who may be at-risk for perceiving their transition process as poor, what factors may be associated with transition outcomes and what strategies might be instituted to increase the likelihood of a good outcome.

Funding

  • NIDDK Support

Digital Object Identifier (DOI)