Effectiveness of nurse-led tele-nephrology interventions in chronic kidney disease management: a systematic review

Abstract

Nurse-led telehealth is emerging as a powerful tool in chronic kidney disease care, improving treatment adherence, patient satisfaction and access to support while showing potential to reduce hospital use. As evidence continues to grow, these personalised, collaborative models are becoming an increasingly important part of modern kidney care. Chronic kidney disease and its sequelae impose substantial clinical and economic burdens worldwide. Although tele-nephrology has emerged as a promising approach to extend specialist support, most programmes are physician-led, and the unique contributions of nurse-led telehealth models remain insufficiently characterised. To systematically review and synthesise evidence on the effectiveness of nurse-led tele-nephrology interventions for adults with chronic kidney disease, dialysis dependency or kidney transplantation, focusing on clinical outcomes, treatment adherence, quality of life, patient satisfaction and healthcare use. A systematic review with narrative synthesis was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines. Studies published in English between 2015 and 2025 were identified from five databases. Eligible studies evaluated telehealth interventions involving nurses and reported clinical, behavioural or patient-reported outcomes. Quality was appraised using the Mixed Methods Appraisal Tool. Seven studies were included. Interventions included telephone follow-ups, video consultations, messaging apps and remote patient monitoring. Nurse-led tele-nephrology consistently improved treatment adherence, discharge readiness and patient satisfaction. Studies showed reduced hospital admissions or emergency visits. Video and phone modalities were effective for coaching and behavioural support, while mobile messaging improved engagement and self-monitoring. Long-term clinical outcomes such as kidney function and quality of life were variably affected, though no harm was reported. Nurse-led tele-nephrology interventions enhance adherence, satisfaction and select clinical outcomes in chronic kidney disease care. High-quality, multicenter trials are warranted to confirm sustainability, cost-effectivenessnand long-term benefits, and to inform scalable, nurse-driven digital kidney care models. Nurse-led telehealth should be considered as a key component of routine CKD care to support treatment adherence, improve patient engagement and satisfaction, and potentially reduce hospital utilisation. Successful implementation requires personalised, accessible telehealth models integrated within multidisciplinary kidney care teams, with ongoing evaluation to optimise long-term patient outcomes.