Abstract:Objective To evaluate the impact of a comprehensive continuum-of-care management model, delivered via multiple digital platforms, on renal function, medication adherence, and self-management ability in patients with chronic kidney disease (CKD), and to provide a reference for optimizing the management of this patient population throughout their care journey. Methods A total of 72 patients with CKD were randomly assigned to either a control group (n=36) or an intervention group (n=36).The control group received standard nursing care, while the intervention group additionally received a 6-month, platform-based comprehensive continuum-of-care management program spanning from outpatient clinic to post-discharge.This program utilized WeChat groups, official WeChat accounts, Douyin (TikTok), and the dedicated "KidneyCare" mobile application.Renal function parameters (blood urea nitrogen, serum creatinine, estimated glomerular filtration rate), medication adherence, and self-management ability were compared between the two groups before and after the intervention. Results After the intervention, the intervention group showed significantly lower levels of blood urea nitrogen and serum creatinine, and a significantly higher estimated glomerular filtration rate compared to the control group (all P<0.05).Scores for medication adherence and self-management ability were also significantly higher in the intervention group (all P<0.05). Conclusion Comprehensive continuum-of-care management utilizing multiple digital platforms can improve renal function, medication adherence, and self-management ability in patients with CKD, contributing to slowing disease progression.