Dietary interventions with dietitian involvement in adults with chronic kidney disease: A systematic review

Tamara Brown, Harriet Williams, Bruno Mafrici, Helena Jackson, Lina Johansson, Fiona Willingham, Ashleigh McIntosh, Helen MacLaughlin

Research output: Contribution to journalArticlepeer-review


Background: A comprehensive evidence base is needed to support recommendations
for the dietetic management of adults with chronic kidney disease (CKD). The
present study aimed to determine the effect of dietary interventions with dietitian
involvement on nutritional status, well-being,
kidney risk factors and clinical outcomes
in adults with CKD.
Methods: Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE,
PsycINFO and were searched from January 2000 to November 2019.
Intentional weight loss and single nutrient studies were excluded. Risk of bias was
assessed using the Cochrane risk-of-
tool. Effectiveness was summarised using
the mean difference between groups for each outcome per study.
Results: Twelve controlled trials (1906 participants) were included. High fruit and
vegetable intake, as well as a multidisciplinary hospital and community care programme,
slowed the decline in glomerular filtration rate in adults with stage 3–4
CKD. Interventions addressing nutrition-related
barriers increased protein and energy
intake in haemodialysis patients. A Mediterranean diet and a diet with high n-3
polyunsaturated fatty acids improved the lipid profile in kidney transplant recipients.
Conclusions: A limited number of studies suggest benefits as a result of dietary interventions
that are delivered by dietitians and focus on diet quality. We did not identify
any studies that focussed on our primary outcome of nutritional status or studies that
examined the timing or frequency of the nutritional assessment. This review emphasises
the need for a wider body of high-quality
evidence to support recommendations
on what and how dietetic interventions are delivered by dietitians for adults with CKD.
Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalJournal of Human Nutrition and Dietetics
Publication statusPublished - 8 Mar 2021


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