CommunityRx-Kidney Health
University of North Carolina, Chapel Hill
634 participants
Mar 1, 2026
INTERVENTIONAL
Conditions
Summary
In the United States, the burden of chronic kidney disease (CKD) rests disproportionately on rural communities. This study evaluates the implementation and effectiveness of CommunityRx-Kidney Health (CRx-K); this health information technology intervention integrates medical, social, and self-care resources to improve CKD management in rural eastern North Carolina. Through a partnership among local primary care centers, community organizations, and researchers, CRx-K will strengthen rural care networks, improve CKD management, and enhance the well-being of rural communities.
Eligibility
Inclusion Criteria2
- Diagnosis of chronic kidney disease defined as ≥1 ICD-10 CKD codes (excluding end-stage kidney disease) or CKD biomarkers (estimated glomerular filtration rate ≤ 60 ml/min, albuminuria ≥30 mg/24h)
- At least one clinic visit at Goshen Medical Center in 12 months before enrollment
Exclusion Criteria4
- Limited life expectancy (e.g., advanced cancer, end-stage liver disease, hospice)
- Active cancer treatment
- Living in a skilled nursing facility
- Dementia/other significant cognitive impairment/inability to participate in the informed consent process
Interventions
CommunityRx-Kidney Health (CRx-K) is an evidence-based, low-intensity, health information technology-driven intervention designed to support chronic kidney disease management in rural eastern North Carolina. CRx-K integrates medical (e.g., blood pressure and glucose monitoring, eye and foot care), social (food, housing, transportation), and self-care (weight and stress management, exercise) resources. CRx-K comprises three components: brief education on integrated chronic kidney disease needs, a personalized community resource referral list (HealtheRx), and clinic navigator-led, longitudinal support (12 months) for chronic kidney disease patients.
Locations(1)
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NCT07237295