Supplemental Material for: Barriers to Person-Centered CKD Care: A Qualitative Study of Multidisciplinary Nephrology Clinicians

We examined nephrology clinicians’ perspectives on patient preparation, dialysis decision-making, and structural barriers to inform multilevel intervention.</p><p dir="ltr">Methods</p><p dir="ltr">A qualitative descriptive study using semi-structured interviews and thematic analysis following Braun and Clarke’s (2006) approach [29] included 22 English-speaking nephrology clinicians recruited via snowball sampling.

Transcripts were analyzed thematically.</p><p dir="ltr">Results</p><p dir="ltr">Three themes emerged. First, CKD awareness, education, and preparedness: patient awareness was uneven and often absent even under nephrology care; education was multidisciplinary and stage-sensitive but emotionally constrained. Second, dialysis decision-making: planned outpatient initiation was distinguished from unplanned emergency starts, the latter associated with reduced patient choice and worse outcomes; modality discussions typically began at an estimated glomerular filtration rate (eGFR) of approximately 20 mL/min/1.73m² but timing varied widely; nephrology clinicians sometimes omitted home dialysis options when patient support seemed uncertain; and family involvement was central to adherence and decision quality.