Effectiveness of comprehensive medical care support by healthcare professionals, including nurses, in patients with chronic kidney disease: a systematic review and meta-analysis

Abstract Background This study aimed to evaluate the effectiveness of comprehensive medical care support (CMCS) by healthcare professionals, including nurses, for patients with chronic kidney disease (CKD) in the preservation phase. Methods All relevant studies were identified through comprehensive literature searches conducted in PubMed (MEDLINE) and Ichushi-Web. Randomized controlled trials involving patients aged ≥ 18 years with dialysis-independent CKD were included. The trials had to include nurses in the intervention details and provide CMCS by two or more healthcare professionals. Results A total of 20 studies were included in the systematic review, of which 14 were eligible for meta-analysis. A significant positive effect of CMCS was observed in terms of physical function, quality of life (QOL), and self-management ability. However, in the pooled analysis, no significant differences regarding renal function and blood pressure were found between the groups. Conclusions The findings suggest that multidisciplinary team-based CMCS, including nursing involvement, may be associated with improvements in physical function, quality of life, and self-management in patients with CKD; however, substantial heterogeneity across studies warrants cautious interpretation and generalization. PROSPERO registration no. CRD42024529378.