Establishing Research Priorities in Geriatric Nephrology: A Delphi Study of Clinicians and Researchers

Catherine R Butler¹, Akanksha Nalatwad², Katharine L Cheung³, Mary F Hannan⁴, Melissa D Hladek⁵, Emily A Johnston⁶, Laura Kimberly⁷, Christine K Liu⁸, Devika Nair⁹, Semra Ozdemir¹⁰, Fahad Saeed¹¹, Jennifer S Scherer¹², Dorry L Segev¹³, Anoop Sheshadri¹⁴, Karthik K Tennankore¹⁵, Tiffany R Washington¹⁶, Dawn Wolfgram¹⁷, Nidhi Ghildayal², Rasheeda Hall¹⁸, Mara McAdams-DeMarco¹⁹

Affiliations

¹ Division of Nephrology, Department of Medicine, Kidney Research Institute, University of Washington, Seattle, Washington; Veterans Affairs Health Services Research and Development Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington.
² Department of Surgery, New York University Grossman School of Medicine and Langone Health, New York, New York.
³ Division of Nephrology, Department of Medicine, The University of Vermont Larner College of Medicine, Burlington, Vermont.
⁴ Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois.
⁵ School of Nursing, Johns Hopkins University, Baltimore, Maryland.
⁶ Division of Geriatrics and Palliative Care, Department of Medicine, New York University Grossman School of Medicine and Langone Health, New York, New York.
⁷ Hansjörg Wyss Department of Plastic Surgery, Department of Population Health, Division of Medical Ethics, New York University Grossman School of Medicine and Langone Health, New York, New York.
⁸ Geriatric Research and Education Clinical Center, Veteran Affairs Palo Alto Health Care System, Palo Alto, California; Section of Geriatric Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California.
⁹ Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee; Tennessee Valley Veterans Affairs Health System, Nashville, Tennessee.
¹⁰ Department of Population Health Sciences, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
¹¹ Divisions of Nephrology and Palliative Care, Departments of Medicine and Public Health, University of Rochester Medical Center, Rochester, New York.
¹² Division of Geriatrics and Palliative Care, Division of Nephrology, Department of Internal Medicine, New York University Grossman School of Medicine and Langone Health, New York, New York.
¹³ Department of Surgery, New York University Grossman School of Medicine and Langone Health, New York, New York; Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Population Health, New York University Grossman School of Medicine and Langone Health, New York, New York.
¹⁴ Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California; Nephrology Section, San Francisco Veterans Affairs Medical Center, San Francisco, California.
¹⁵ Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
¹⁶ College of Social Work, University of Tennessee, Knoxville, Tennessee.
¹⁷ Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Medicine Division, Milwaukee Veterans Affairs Medical Center, Milwaukee, Wisconsin.
¹⁸ Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Renal Section, Durham Veterans Affairs Healthcare System, Durham, North Carolina.
¹⁹ Department of Surgery, New York University Grossman School of Medicine and Langone Health, New York, New York; Department of Population Health, New York University Grossman School of Medicine and Langone Health, New York, New York. Electronic address: mara.mcadamsdemarco@nyulangone.org.

PMID: 39603330
PMCID: PMC11846693 (available on 2026-03-01)
DOI: 10.1053/j.ajkd.2024.09.012

Establishing Research Priorities in Geriatric Nephrology: A Delphi Study of Clinicians and Researchers

Catherine R Butler et al. Am J Kidney Dis. 2025 Mar.

. 2025 Mar;85(3):293-302.

doi: 10.1053/j.ajkd.2024.09.012. Epub 2024 Nov 26.

Authors

Affiliations

¹ Division of Nephrology, Department of Medicine, Kidney Research Institute, University of Washington, Seattle, Washington; Veterans Affairs Health Services Research and Development Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington.
² Department of Surgery, New York University Grossman School of Medicine and Langone Health, New York, New York.
³ Division of Nephrology, Department of Medicine, The University of Vermont Larner College of Medicine, Burlington, Vermont.
⁴ Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois.
⁵ School of Nursing, Johns Hopkins University, Baltimore, Maryland.
⁶ Division of Geriatrics and Palliative Care, Department of Medicine, New York University Grossman School of Medicine and Langone Health, New York, New York.
⁷ Hansjörg Wyss Department of Plastic Surgery, Department of Population Health, Division of Medical Ethics, New York University Grossman School of Medicine and Langone Health, New York, New York.
⁸ Geriatric Research and Education Clinical Center, Veteran Affairs Palo Alto Health Care System, Palo Alto, California; Section of Geriatric Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California.
⁹ Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee; Tennessee Valley Veterans Affairs Health System, Nashville, Tennessee.
¹⁰ Department of Population Health Sciences, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
¹¹ Divisions of Nephrology and Palliative Care, Departments of Medicine and Public Health, University of Rochester Medical Center, Rochester, New York.
¹² Division of Geriatrics and Palliative Care, Division of Nephrology, Department of Internal Medicine, New York University Grossman School of Medicine and Langone Health, New York, New York.
¹³ Department of Surgery, New York University Grossman School of Medicine and Langone Health, New York, New York; Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Population Health, New York University Grossman School of Medicine and Langone Health, New York, New York.
¹⁴ Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California; Nephrology Section, San Francisco Veterans Affairs Medical Center, San Francisco, California.
¹⁵ Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
¹⁶ College of Social Work, University of Tennessee, Knoxville, Tennessee.
¹⁷ Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Medicine Division, Milwaukee Veterans Affairs Medical Center, Milwaukee, Wisconsin.
¹⁸ Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Renal Section, Durham Veterans Affairs Healthcare System, Durham, North Carolina.
¹⁹ Department of Surgery, New York University Grossman School of Medicine and Langone Health, New York, New York; Department of Population Health, New York University Grossman School of Medicine and Langone Health, New York, New York. Electronic address: mara.mcadamsdemarco@nyulangone.org.

PMID: 39603330
PMCID: PMC11846693 (available on 2026-03-01)
DOI: 10.1053/j.ajkd.2024.09.012

Abstract

Rationale & objective: Despite substantial growth of the population of older adults with kidney disease, there remains a lack of evidence to guide clinical care for this group. The Kidney Disease and Aging Research Collaborative conducted a Delphi study to build consensus on research priorities for clinical geriatric nephrology.

Study design: Asynchronous modified Delphi study.

Setting & participants: Clinicians and researchers in the United States and Canada with clinical experience and/or research expertise in geriatric nephrology.

Outcome: Research priorities in geriatric nephrology.

Analytical approach: In the first Delphi round, participants submitted free-text descriptions of research priorities considered important for improving the clinical care of older adults with kidney disease. Delphi moderators used inductive content analysis to group concepts into categories. In the second and third rounds, participants iteratively reviewed topics, selected their top 5 priorities, and offered comments used to revise categories.

Results: Among 121 who were invited, 57 participants (47%) completed the first Delphi round and 48 (84% of enrolled participants) completed all rounds. After 3 rounds, the 5 priorities with the highest proportion of agreement were (1) communication and decision-making about treatment options for older adults with kidney failure (69% agreement), (2) quality of life, symptom management, and palliative care (67%), (3) frailty and physical function (54%), (4) tailoring therapies for kidney disease to specific needs of older adults (42%), and (5) caregiver and social support (35%). Health equity and person-centricity were identified as cross-cutting features that informed all topics.

Limitations: Relatively low response rate and limited participation by private practitioners and older clinicians and researchers.

Conclusions: Experts in geriatric nephrology identified clinical research priorities with the greatest potential to improve care for older adults with kidney disease. These findings provide a road map for the geriatric nephrology community to harmonize and maximize the impact of research efforts.

Keywords: Delphi study; geriatric nephrology.

PubMed Disclaimer

References

1. Johansen KL, Chertow GM, Gilbertson DT, et al. US Renal Data System 2022 Annual Data Report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2023;81(3)(suppl 1):A8–A11. doi: 10.1053/j.ajkd.2022.12.001 - DOI - PMC - PubMed
1. Perez Fernandez M, Martinez Miguel P, Ying H, et al. Comorbidity, Frailty, and Waitlist Mortality among Kidney Transplant Candidates of All Ages. Am J Nephrol. 2019;49(2): 103–110. - PMC - PubMed
1. Prichard SS. Comorbidities and their impact on outcome in patients with end-stage renal disease. Kidney Int. 2000;57(Suppl 74): S100–S104. doi: 10.1046/j.1523-1755.2000.07417.x - DOI
1. Fwu CW, Eggers PW, Norton JM, et al. Age- and Race-Specific Changes in ESKD Incidence over Four Decades. J Am Soc Nephrol. 2024;35(4):456–465. doi: 10.1681/ASN.0000000000000310. - DOI - PMC - PubMed
1. Gupta R, Woo K, Yi JA. Epidemiology of end-stage kidney disease. Semin Vasc Surg. 2021;34(1): 71–78. - PMC - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Establishing Research Priorities in Geriatric Nephrology: A Delphi Study of Clinicians and Researchers

Affiliations

Establishing Research Priorities in Geriatric Nephrology: A Delphi Study of Clinicians and Researchers

Authors

Affiliations

Abstract

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources