Multimodal Strategies for Improving Health Literacy in Adults with CKD

Health literacy (HL), encompassing functional, interactive (communicative), and critical abilities, is essential for effective self-management in CKD. This discussion article, using a scoping review approach, draws from recent studies published between January 2021 and March 2025 to understand the latest HL interventions in adults with CKD. HL in this population is multifaceted and tied to social determinants of health. Low HL is linked to poorer outcomes. While recent research focused on educational interventions, few used strategies such as teach-back. Objectively measured outcomes ( e.g ., eGFR, BP, and interdialytic weight gain) showed modest improvements, whereas patient-reported outcomes ( e.g ., self-management behavior, disease-related knowledge, self-efficacy, and health-related quality of life) improved more consistently when HL abilities were targeted. Vulnerable groups, particularly those with low HL or early CKD grades, remain underrepresented. To slow disease progression and improve equity, targeted interventions are urgently needed. HL must also be embedded in organizational policies, health care service design, and workforce training to achieve sustainable impact. As a socially determined factor tied to health equity, a multimodal HL approach is essential and requires a shift from individual abilities to health care professionals and organizations. Codesign research can strengthen intervention relevance and uptake by incorporating diverse perspectives and real-world contexts. This collaborative approach offers a pathway to create inclusive, practical, and culturally responsive solutions that advance HL practices of clinicians and improve CKD outcomes.