EFFECTS OF TELENURSING IN PREDIALYSIS PATIENTS

This study aims to evaluate the effect of tele-nursing practices on quality of life and clinical outcomes in predialysis patients with chronic kidney disease. The study will be conducted with patients diagnosed with stage 3A, 3B, or 4 chronic kidney disease who are followed in a nephrology outpatient clinic. Participants will be assigned to intervention and control groups. Patients in the intervention group will receive a structured tele-nursing program including patient education, telephone or online follow-up, reminders, and counseling for disease management. Patients in the control group will continue to receive routine outpatient care. Quality of life, medication adherence, self-care management, blood pressure, body weight, edema status, and laboratory parameters such as eGFR, creatinine, blood urea nitrogen, potassium, phosphorus, calcium, albumin, hemoglobin, and bicarbonate will be evaluated at baseline, 3 months, and 6 months. The study is expected to show whether tele-nursing support can improve quality of life, self-care behaviors, treatment adherence, and clinical outcomes in predialysis patients.

Inclusion Criteria: * Being 18 years of age or older Having a diagnosis of stage 3A, 3B, or 4 chronic kidney disease Having an estimated glomerular filtration rate between 15 and 59 mL/min/1.73 m² Being followed in the nephrology outpatient clinic for at least 3 months Not receiving dialysis treatment Being able to communicate in Turkish Having access to a telephone or smart device suitable for tele-nursing follow-up Being able to participate in telephone, messaging, or online follow-up Voluntarily agreeing to participate in the study Providing informed consent Exclusion Criteria: * Having stage 1,2 and 5 chronic kidney disease Receiving hemodialysis or peritoneal dialysis treatment Having a history of acute kidney injury within the last 3 months Having a terminal illness Having severe cognitive impairment, psychiatric disorder, or communication problem that prevents participation in the study Having hearing, speech, or visual impairment that prevents effective tele-nursing communication Not having access to the required communication tools for remote follow-up Participating in another interventional study that may affect the outcomes of this research Refusing to participate in the study Withdrawing informed consent during the study period