Objective To explore the effect of extension mode based on four actions combined with probiotics intervention in patients with chronic renal failure. Methods Ninety-two patients with chronic renal failure from the Second Affiliated Hospital of Zhengzhou University from June 2022 to January 2024 were selected as the study objects, and were divided into probiotic group and action group by random number table method. The two groups were given traditional nursing intervention, the probiotic group received probiotic intervention, and the action group added extension mode based on four actions based on the probiotic group to compare the renal function, intestinal barrier function and quality of life of patients in the two groups. Results After 3 months of intervention, the levels of urea nitrogen (BUN) and blood creatinine (Scr) in two groups were lower than those before intervention, and those in the action group were lower than those in the probiotic group (P<0.05). After 3 months of intervention, the levels of endotoxin and D-lactic acid in two groups were lower than before intervention, and those in the action group were lower than those in the probiotic group (P<0.05). After 3 months of intervention, the scores of energy, social function and physical health in the two groups were higher than those before intervention, and those in the action group were higher than those in the probiotic group (P<0.05). Conclusion Extension mode based on four actions combined with probiotics, intestinal barrier function can be regulated, renal function can be regulated and quality of life can be improved in patients with chronic renal failure.