Cardiovascular disease is one of the most common complications for people living with chronic kidney disease (CKD).

When heart issues arise, patients are often asked to consider invasive tests or procedures—choices that can offer real benefits but may also pose risks to kidney function.

To help patients and care teams navigate these complex decisions, the APPROACH project within the Can-SOLVE CKD Network developed a new patient-centred decision aid called My Heart and CKD. The tool provides personalized, easy-to-understand information about the potential benefits and risks of cardiovascular testing and is now being piloted in major cardiac units in Edmonton and Calgary.

Designed to meet the needs of patients and doctors

People with CKD face elevated rates of cardiovascular events, such as heart attacks and stroke. At the same time, some heart-related tests can contribute to kidney injury. Without clear, tailored information, patients may feel uncertain about whether to undergo testing or treatment.

The My Heart and CKD decision aid was created to support more informed, values-aligned conversations between patients and their care teams in these scenarios. The APPROACH research team first used data from thousands of patients with CKD in Alberta and B.C. to develop and validate algorithms that estimate an individual’s likelihood of benefit versus kidney injury under different diagnostic or treatment options.

They also conducted extensive consultation and studies with patients and doctors to understand their decision-making challenges when it comes to cardiovascular testing. That information was used to create a step-by-step guide that, when combined with the algorithm, supports patients and doctors in making informed decisions that align with the patient’s unique risks, preferences, and values. My Heart and CKD is free to use and available online at myheartandckd.ca.

“We’ve worked with many patients and cardiologists over the last few years to incorporate their perspectives and needs,” explains Denise Kruger, a project coordinator for APPROACH. “Their input was really valuable.”

As a result of these consultations and multiple rounds of usability testing, the tool is approachable and intuitive—using colour-coded risk results, clear explanations, and a glossary of medical terms. Input from Indigenous and elderly patients, as well as rural residents, helped ensure the tool is accessible to people from many backgrounds and with varying levels of health literacy.

Real-world testing across Alberta cardiology clinics

The team is now evaluating My Heart and CKD in a pilot implementation trial involving patients with CKD and heart disease at 10 cardiology practices across Alberta. The trial is assessing feasibility, workflow integration, patient and provider experience, knowledge gained, decision-making confidence, and how closely decisions align with patients’ values.

Clinician interviews to date point to strong enthusiasm for the tool, along with practical considerations—such as the extra time required to review risk and benefit information with patients. These insights will guide workflow refinements as the team prepares for future scale-up.

Looking ahead to broader use

The results of the pilot, expected within a year, will show how the decision aid performs in real-world clinical settings and help shape plans for broader implementation across Canada.

For Pantea Javaheri, an APPROACH project coordinator who has been part of the team since its inception in 2016, seeing the tool move into clinics has been deeply rewarding. “It’s just really cool to see it come to fruition, and to see that [My Heart and CKD] actually makes an impact,” she says. Noting how patients have already expressed appreciation for how the tool supports their decision-making, she adds, “Imagining how it could potentially happen on a bigger scale—that’s quite exciting.”

Empowering patients through shared decision-making

For Maureena Loth, a Dene Suline from Cold Lake, Alberta, in Treaty Six territory, and a patient partner on the project, the tool represents a shift in how patients engage with the health system.

Dr. Matt James, nephrologist and co-PI (left) and patient partner Maureena Loth (right)

“The tool allows empowerment… patients [are] being respected,” she says. “I come from… [the] old school, where if you had an illness or disease or you’re injured, you went into the medical system. You had no idea what was going on. You had no choice or say in what they were doing. But with this tool, patients [are] being respected.”

Loth’s message to clinicians is clear: “[This] tool is building the relationship between the doctor and the patient. It’s also supporting the patient, respecting the patient, and allowing them to [make choices].”

To learn more about the APPROACH project and watch a video where researchers and patients explain what led to the development of the My Heart and CKD decision aid, visit the APPROACH project page.