The Role of Comprehensive Renal Clinic in Chronic Kidney Disease Stabilization and Management: The Northwestern Experience

In this article, we maintain that the management of patients with chronic kidney disease (CKD) is best provided in a clinic setting that Integrates nephrologic expertise, patient education, and comprehensive supportive services. Our experience with a CKD clinic in an urban academic setting Is described. As a way to assess and quantify the impact of our clinic on clinical outcomes, we have analyzed our results in terms of 2 variables: presence of permanent access at the time of dialysis initiation and impact on renal function as assessed by calculated glomerular filtration rate (GFR). The number of clinic visits was taken as an index of comprehensive renal care before dialysis initiation. Individuals who started dialysis with a functioning permanent access had been seen In our clinic more frequently than those seen less frequently (20 ± 3.5 and 4.4 ± 2.1 visits, respectively, P