Patient Education in Chronic Kidney Disease: From Information Delivery to Structured Self-Management Support

Objective: To synthesize the evidence on patient education across the chronic kidney disease (CKD) course, distinguish educational outcomes from treatment uptake and propose an Assess–Support–Reassess (ASR) approach. Methods: This focused narrative review uses non-systematic literature searches and purposive selection of reviews, clinical guidance and primary studies relevant to adult CKD education, self-management, health literacy and treatment decision-making. It provides a selective, interpretive synthesis rather than an exhaustive or reproducible systematic review. Results: Among the publications reviewed, several reported short-term improvements in knowledge and self-efficacy, although the findings varied across interventions and outcome measures. Selected self-management behaviors may have improved, but sustained capability and objectively measured adherence showed mixed results. Observational studies associated educational and multidisciplinary pathways with better KRT preparation; their effects on broader decision quality remain insufficiently established. Their effects on home dialysis uptake, CKD progression, hospitalization, mortality and costs remain uncertain. Health literacy reflects individual and organizational factors, while digital approaches introduce engagement and equity challenges. ASR links stage-responsive assessment, tailored skills-oriented support and reassessment across the CKD course. Conclusions: CKD education is best understood as an adaptive communication and self-management process rather than a one-time transfer of information. Practice implications: CKD services should assess needs and barriers, provide personalized skills-oriented support using teach-back and decision support, assign multidisciplinary responsibility, and reassess understanding and readiness as circumstances change.