Evidence-based nursing strategies and quality of life in Saudi CKD patients with cardio-renal-metabolic comorbidities

AIM/OBJECTIVE: This study explored the impact of evidence-based nursing management strategies on quality of life (QoL) among Saudi patients with chronic kidney disease (CKD) and cardio-renal-metabolic (CKM) comorbidities. BACKGROUND: CKD poses a significant health burden in Saudi Arabia, often compounded by CKM comorbidities such as hypertension and diabetes. Nurse-led interventions are critical in promoting adherence to management strategies, yet limited evidence exists on their effect within this population. DESIGN: A cross-sectional quantitative study was conducted among 285 adult CKD patients (stages 3–5). METHODS: Participants completed a validated questionnaire assessing adherence to management strategies (medication, diet, self-monitoring, education, and physical activity) and QoL using the Kidney Disease Quality of Life instrument. Regression modeling identified predictors of QoL. RESULTS: Adherence to management strategies explained 46.5% of the variance in QoL scores (R² = 0.465, β = 0.682, p < 0.001). Patients with high adherence scored 0.43 points higher on the KDQOL scale compared with low-adherence peers. Medication adherence was highest (81.5%), while physical activity adherence was lowest (58.9%). QoL declined progressively with longer CKD duration (3.91 at < 1 year vs. 3.45 at > 5 years, p = 0.003). CONCLUSIONS: Nurse-led, evidence-based management strategies significantly improve QoL among Saudi CKD patients with CKM comorbidities. Early, culturally tailored interventions are essential to address low adherence in areas such as physical activity. CLINICAL TRIAL NUMBER: Not applicable.