Bridging the Generational Divide in Kidney Health Care Transition Preparation: Adapting to Gen Z and Alpha in a Digital Age.

Raina, Rupesh; Subhash, Sanat; Tanna, Shay; Bajpai, Ruhaan; Yap, Hui Kim; de Ferris, Maria Díaz-González; Verghese, Priya S · J Am Soc Nephrol · 2026

review · Level V

Where this comes from

Abstract

Health care transition from pediatric-focused to adult-focused nephrology care comes with significant challenges for adolescents/young adults with kidney disease, their caregivers, and the pediatric-focused and adult-focused practitioners. As younger generations enter this period, transition preparation strategies need to better align with their preferences for autonomy and digital fluency. This scoping review focused on several structured protocols, such as the Recognition, Insight, Self-Reliance, and Establishment of Healthy Habits to Transition model; Self-Management and Transition to Adulthood with R x ; ON Taking Responsibility for Adolescent/Adult Care; Ready Steady Go/Plain Language, Engagement, Empathy, Empowerment, Respect; and others, evaluating their adaptability to younger generations' preferences. This review also highlights barriers posed by emerging technological tools, such as limitations of resources and inconsistent physician coordination. Finally, the role of caregivers is explored, underscoring the importance of early preparation to foster independence and address transition preparation needs. Ultimately, successful preparation and transfer of care require the development of thoughtful and equitable digital tools. Adjusting protocols to meet the expectations of adolescents and young adults may improve adherence and long-term outcomes after their transfer to adult-focused health care.