Collaborative program to improve kidney care for Black patients at Emory

Improving Access to Nephrology Treatment and Care Among Patients at Greatest Risk for Kidney Failure

Not applicable Interventional Emory University · NCT06693661

This test uses kidney health coaching and clinic decision support to see if it can delay the need for dialysis, central venous catheters, or death in Black adults with advanced chronic kidney disease who receive care through Emory.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment600 (estimated)
Ages18 Years and up
SexAll
SponsorEmory University Academic / other
Locations1 site (Atlanta, Georgia)
Trial IDNCT06693661 on ClinicalTrials.gov

What this trial studies

This is a community-engaged, two-group randomized trial that combines clinical decision support (CDS) with a six-month kidney health coaching (KHC) intervention delivered by trained coaches who have lived experience with CKD. The CDS is designed to streamline screening, identification, and linkage to care across primary, acute, and nephrology settings. The KHCs follow the Chronic Care Model to support self-management, treatment decision-making, and connections to community resources. Primary outcomes include time to kidney replacement therapy or central venous catheter use and death, and enrollment and baseline assessments are conducted by telephone.

Who should consider this trial

Good fit: Black or African American adults with advanced CKD (two eGFRs <29 at least 90 days apart or a KFRE ≥10%) who had a recent encounter at Emory University Hospital Midtown and are willing to complete telephone consent and follow-up.

Not a fit: People already on dialysis, with prior transplant, receiving hospice or active cancer treatment, non-English speakers, or those not engaged in Emory care are not eligible and unlikely to receive benefit from this intervention.

Why it matters

Potential benefit: If successful, the program could help delay dialysis or catheter use and reduce mortality by improving self-management and connection to care for patients with advanced CKD.

How similar studies have performed: Related coaching and Chronic Care Model–based programs have improved patient engagement and care processes in CKD, but evidence that they specifically delay dialysis or reduce mortality is limited, making this a relatively novel test for those endpoints.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Identifies as African American or Black
* Two estimated glomerular filtration rates (eGFRs) \< 29 separated by at least 90 days but within the past 2 years or a Kidney Failure Risk Equation (KFRE) score of 10% or greater likelihood of kidney failure within the next 2 years
* Had an encounter at Emory University Hospital-Midtown through an ambulatory visit or inpatient stay (i.e., ER or hospital visit within the previous 2 months
* Stated willingness to comply with all study procedures and availability for the duration of the study

Exclusion Criteria:

* Currently on dialysis
* currently receiving hospice care or other types of conservative management for terminal illness
* Currently on waitlist, or referred for/or completed a transplant evaluation visit within the past 2 years
* Kidney or another solid organ transplant
* Active cancer treatment
* Non-English speaking
* Participating in another treatment or intervention study at the time of enrollment
* Currently pregnant or planning to become pregnant at the time of recruitment

Where this trial is running

Atlanta, Georgia

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Kidney DiseasesAfrican AmericanHealth DisparitiesChronic Care ModelKidney Health Coach
Last reviewed 2026-06-09 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.