This study aims to analyze the effects of AI-based risk prediction for graft loss on the frequency of conversations about the treatment after graft loss, as well as the associated shared decision making process in post-kidney transplant care in a German kidney transplant center (KTC), as perceived by the patient, their support person and the clinician/physician. Second, it aims to explore changes in patient and support person recall at 12 months follow-up. Implementation barriers and enablers will also be assessed. The protocol was amended so that the initially planned 24 months observation timeframe was removed from the study and it ended after 12 months due to high attrition and funding restrictions.

Inclusion Criteria:

• written informed consent
• patients with functioning kidney allograft
• > 12 months after transplantation
• eGFR < 30 ml/min/1.73m2 according to CKD-EPI 2021 formula
• at least 18 years of age
• ability to communicate in German
• regular follow-up at kidney transplant center

Exclusion Criteria:

• multi-organ transplantation
• eGFR > 30 ml/min/1.73m2 according to CKD-EPI 2021 formula
• <= 12 months after transplantation
• less than 18 years of age
• not able to communicate in German
• no regular follow-up at kidney transplant center
• enrollment in another interventional study less than 1 month before participation in this study

All genders (male, female, and others) are eligible for this study.