Evaluation of a nurse-led chronic kidney disease clinic: a single centre cohort study

Abstract Aim To evaluate the clinical outcomes and patient satisfaction of a new nurse practitioner chronic kidney disease clinic. Methods This was a prospective cohort study of all patients who had their first appointment with the early CKD nurse practitioner from October 2023 to October 2024, with data extracted on 1 April 2025. The outcomes were assessed across three domains: (1) change in clinical outcomes of kidney function, albuminuria and blood pressure, (2) prescription of guidelines concordant medications and (3) patient satisfaction with care as assessed by a survey. Results There were 95 patients with a median age of 63 years (IQI 51–76) and 45.3% were female. Cardiometabolic co-morbidity was common; 82.8% of patients had hypertension, 55.6% diabetes and 25.2% cardiovascular disease. At referral the median urine albumin creatinine ratio was 32.3 mg/mmol (IQ1 11.2–53.5) and this was lower at discharge, 12.4 mg/mmol (IQI 2.9–25.3, P < 0.001). Systolic and diastolic blood pressure were lower at discharge (mean difference mmHg [95% CI, p value]: 10.1 [6.58–13.54, <0.001] and 5.2 [2.6–7.7, <0.001] respectively). There was no change in median estimated glomerular filtration rate. More patients at discharge were on a renin angiotensin system inhibitor (88.4% versus 76.8%), sodium-glucose co-transporter 2 inhibitor (53.6% versus 28.4%), mineralocorticoid receptor antagonist (23.1% versus 5.2%) and glucagon-like peptide-1 receptor agonist (23.1% versus 9.6%). The survey response rate was 51.6% with patients reporting high satisfaction with the service. Conclusion The CKD nurse practitioner clinic was effective at implementing guideline directed medical therapies for early CKD and associated with improvements in blood pressure and albuminuria.