Kidney Week

Abstract: FR-PO0266

The Power of Human-Centered Multidisciplinary Care in CKD: Real-World Outcomes from a Single-Center Cohort

Session Information

• CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Miyata, Hitomi, Kyoto Katsura Byoin, Kyoto, Kyoto Prefecture, Japan

Hitomi Miyata, MD, PhD

• Mizote, Aya, Kyoto Katsura Byoin, Kyoto, Kyoto Prefecture, Japan

Aya Mizote, R.Ph

• Miyake, Takafumi, Kyoto Katsura Byoin, Kyoto, Kyoto Prefecture, Japan

Takafumi Miyake, MD

• Takata, Chisa, Kyoto Katsura Byoin, Kyoto, Kyoto Prefecture, Japan

Chisa Takata, MD

Group or Team Name

• Katsura Team Kidney

Background

Human centered, team based care is increasingly recognized as essential in chronic kidney disease (CKD) management, yet real world evidence from multidisciplinary programs remains limited. This study evaluated whether a human centered, multidisciplinary counseling program could slow renal function decline in patients with CKD.

Methods

We conducted a single center retrospective observational cohort study at Kyoto Katsura Hospital. A total of 176 patients (117 men, 59 women; age 33–91 years, median 70) who received the program between March 2014 and April 2023 and had ≥6 months of observation before and after the intervention were included.
The intervention consisted of a structured four session multidisciplinary program with interviews and counseling by nurses and dietitians, complemented by two pharmacist led sessions focusing on medication review and adherence support. This human centered, team based approach provided integrated lifestyle, dietary, and pharmacological guidance tailored to each patient.
The primary outcome was the annual change in eGFR (ΔeGFR). Pre and post intervention values were compared using the Wilcoxon signed rank test.

Results

CKD stages were G2: 29.0%, G3: 44.3%, and G4: 19.3%. Patients were prescribed a median of 6 medications (0–20). Over the counter drug and supplement use was observed in 38 and 39 patients. The multidisciplinary team collaboratively identified issues related to lifestyle, diet, medication use, and adherence, and provided coordinated, patient centered guidance.
The median ΔeGFR improved significantly from –4.10 to –1.90 mL/min/1.73 m²/year (p < 0.0001).

Conclusion

These real world findings demonstrate that human centered multidisciplinary care can meaningfully slow CKD progression. The program’s effectiveness appears to arise from the synergy of professionals working together, listening to patients, and providing empathetic, coordinated care.

Acknowledgment

We gratefully acknowledge the invaluable contributions of Dr. Gen Yamano, Dr. Kazuaki Nagashima, and all members of the Kidney Team Katsura, whose collaborative efforts and patient centered commitment greatly advanced our CKD and DKD prevention program.