Background: Chronic kidney disease (CKD) affects over 673 million people worldwide and ranks 11th among causes of age-standardised mortality, with a disproportionate burden in sub-Saharan Africa (pooled prevalence 13.9%). Therapeutic adherence remains the main modifiable determinant of disease trajectory, placing therapeutic patient education (TPE) and empowerment at the centre of WHO- and KDIGO-recommended care strategies. Review question: In adults with CKD at any stage (population), what is the effect of structured TPE, empowerment, self-management, or health-literacy interventions (intervention), compared with usual care where reported (comparator), on knowledge, adherence, self-management skills, preparedness for shared decision-making on kidney replacement therapy, and quality of life (primary outcomes), and on hospitalisation and disease progression (exploratory outcomes)—with what implications for sub-Saharan Africa and Niger? Objective: To critically analyse evidence on the impact of TPE and empowerment on adherence, preparation for kidney replacement therapy, quality of life, and clinical outcomes in CKD, and derive implications for sub-Saharan Africa and Niger. Methods: An analytical narrative review followed a documented selection process represented by a PRISMA 2020 flow diagram, searching PubMed/MEDLINE, the Cochrane Library, KDIGO 2024 guidelines, and grey literature from January 2010 to December 2025. Selection and extraction were performed independently in duplicate, with disagreements resolved by consensus. A critical appraisal of the methodological quality of included sources informed the hierarchisation of evidence levels in the narrative synthesis. Of 747 records identified, 56 studies meeting the period criteria were retained after de-duplication, screening, and full-text assessment; one historical reference predating 2010 was added as a founding complement, outside the PRISMA count. Results: Structured TPE programmes (teach-back, multidisciplinary workshops, individualised educational diagnosis) significantly improve knowledge, adherence, and preparedness for shared decision-making on kidney replacement therapy, with increased orientation toward home dialysis and pre-emptive transplantation. Empowerment—a cyclical process linking knowledge, confidence, and self-determination—is associated with improved quality of life and, in mostly observational studies that do not isolate the specific effect of TPE, with reduced hospitalisations and a possible, indirect, moderate-certainty slowing of CKD
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