Bring a large pot of water to boil. Cook pasta according to the package.
While pasta is cooking, cook sausage until cooked through in a large skillet.
Remove from skillet and set aside.
In the same skillet, heat olive oil.
Add onions and cook 5-7 minutes, until translucent.
Add garlic and sage and cook 1 minute.
Season with salt.
Add Alfredo sauce, pumpkin, and nutmeg, and stir to combine.
Over medium heat, bring to a simmer.
Add kale and stir well, incorporating it into the sauce.
Once the pasta is done cooking, combine with sauce and sausage, stirring well to combine.
Top with additional fresh sage and Parmesan cheese.
Serve and enjoy!