Association of continuity of care with treatment adherence and quality of life in patients with chronic kidney disease and hyperkalemia: A retrospective study

This retrospective study evaluated whether a continuity-of-care nursing model was associated with improved adherence and quality of life in patients with chronic kidney disease complicated by hyperkalemia. Medical records of patients hospitalized between January 2021 and December 2023 were reviewed. Based on documented discharge planning and postdischarge follow-up intensity, patients were categorized into a control group receiving routine education and standard follow-up, and a experimental group receiving enhanced transitional and postdischarge nursing. The continuity-of-care approach incorporated structured guidance on fluid restriction, dietary potassium and sodium control, self-care training, disease management, medication counseling, lifestyle modification, weight management, and scheduled follow-up. Outcomes extracted from follow-up documentation included multidomain adherence (fluid restriction, potassium intake control, self-care behaviors, disease management, and sodium intake), preventive-treatment adherence (medication adherence, lifestyle modification, weight management, and follow-up attendance), psychological status assessed by the self-rating anxiety scale and self-rating depression scale, overall quality of life, and satisfaction with care. Compared with usual care, the continuity-of-care group demonstrated higher adherence across multiple domains and better preventive-treatment compliance (all P < .001). After the care period, self-rating anxiety scale and self-rating depression scale scores were lower in the continuity-of-care group, indicating reduced anxiety and depressive symptoms. Quality of life scores and satisfaction with nursing care were higher in the continuity-of-care group than in the usual-care group ( P < .05). These findings suggest that continuity of care is associated with improved adherence and patient-reported outcomes in chronic kidney disease patients with hyperkalemia, although prospective studies are needed to confirm causality.