Many patients with advanced kidney disease don’t know that kidney transplantation is an option, even though it can be lifesaving and improve quality of life. With funding from LDI, a research team built and tested a virtual nephrologist that educates patients with advanced chronic kidney disease (CKD) and their caregivers about kidney transplantation.

In a pilot study, patients spent 12 minutes with the virtual nephrologist. Afterward, they reported stronger intentions to talk with their doctor about kidney transplantation.

One participant said, “I was hesitant, initially, to discuss or even think about kidney transplant since I am at stage 4. However, my mindset has to change as my disease progresses. It’s important to be informed about all things related to kidney transplantation.”

Although the research measured patients’ intentions rather than their actions, the findings suggest an opportunity. With limited access to nephrology care constraining patient education, a virtual nephrologist could offer a scalable way to build engagement and enhance current care for people with advanced kidney disease.

Participants Chose Their Virtual Nephrologist

Study participants accessed the virtual doctor through a link on a smartphone or computer and selected one of four avatars from which they wanted to learn (see Figure 1).

The chosen virtual nephrologist covered important topics related to kidney transplantation, including the benefits, the transplant evaluation process, the waiting list, and living donor transplantation. After each module, participants could indicate whether they wanted more information. They could also pause, repeat, or choose different information at any time. If a participant did not make a selection, the virtual nephrologist covered all the topics in order (see Figure 2). At the end of the session, participants received an email with information and links to local transplant centers.

The study team approached 1,140 individuals with advanced CKD about participating, and 267 agreed to receive the study link connecting them to the virtual nephrologist. Of those, 148 patients (55%) completed surveys and were included in the analyses. The team administered surveys before and after participants engaged with the virtual nephrologist and measured whether they intended to talk with their real-life doctors about kidney transplantation.

After the Virtual Doctor, Participants More Likely to Talk About Transplant in Real Life

Female participants were highly likely to choose a female virtual nephrologist (79%), while 46% of male participants selected a male virtual nephrologist. Most Black participants (71%) chose a dark-skinned nephrologist, while 55% of non-Black participants chose a light-skinned nephrologist. Previous research has found patient preferences for doctors of a similar race and gender.

Patients actively engaged with the virtual nephrologist: 89% redirected the presentation at least once. Patients also responded positively to the tool. After interacting with the virtual nephrologist, they reported increased intentions to speak with their doctors about kidney transplantation.

One participant said, “Virtual doctor was helpful. Spoke at a good pace and I like how I could select more information on topics I wanted regarding kidney transplant and got opportunity to add or change my selections at the end. The presentation also made this topic less intimidating. I am still not sure if I qualify for a transplant but willing to bring this up with my doctor.”

A First Step Toward Virtual Clinicians

This pilot study was funded by LDI’s Research Initiative on Improving Management of Chronic Kidney Disease and had several limitations. The study design did not include a usual-care comparison or control arm, and it did not evaluate clinical outcomes. Much remains to be measured and understood, including the tool’s impact on objective clinical outcomes such as transplant referral, evaluation, and steps toward waitlisting. Still, as the researchers noted, “Virtual clinicians are likely coming to a clinic near you.”

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The study, “An Interactive Virtual Nephrologist to Engage Patients With Advanced CKD About Transplantation,” became available online by the American Journal of Kidney Diseases on July 14, and was published in the October 2026 issue. Authors include Peter P. Reese, Danish Tamboli, Vishnu Potluri, David S. Goldberg, Roshan Venkatakrishnan, Adam Mussell, Sean J. McKenzie, Gabrielle Perez, Leon Chen, Shristi Mapchan, Douglas E. Schaubel, Amanda Leonberg-Yoo, Janice L. Krieger, and Benjamin Lok.

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