Improving the Transition to Adult Care for Young People with Chronic Kidney Disease

The transition from pediatric- to adult-oriented care typically occurs during emerging adulthood, a developmental stage during which the risks of poor treatment adherence and adverse outcomes are elevated. Inadequate support during this change in care environment may augment the risks. With a focus on chronic kidney disease, we will briefly review the evidence linking transition from pediatric- to adult-oriented care to adverse medical, social, and quality of life outcomes, and outline potential reasons for the associations between transition and adverse outcomes. Then we will summarize the recent literature on potential interventions to improve the transition from pediatric- to adult-oriented care. We will examine strategies to improve (1) preparation for transition (including positive youth development, peer mentoring, education, and self-care skill development), (2) the transition process itself (including different models of transition care), and (3) the care structures/systems available for emerging adults within the adult-oriented care environment (including expectations of young people and parents, adaptation of adult care to the emerging adult, and improved education of adult care providers in issues of importance to emerging adults). The perspectives of patients, parents, and healthcare providers will be considered throughout. © 2015, Springer Science + Business Media New York.