Effect of individual and group-based dietitian-delivered education interventions on outcomes for people with chronic kidney disease stages 3a-5: A systematic review and meta-analysis.

Aims

This review aimed to determine the effectiveness of dietitian-delivered nutrition education for people with chronic kidney disease stages 3a-5.

Methods

Four databases were searched up to July 2025. Randomised controlled trials evaluating the effect of dietitian-delivered nutrition education compared to standard care on outcomes [primary: estimated glomerular filtration rate; secondary: blood pressure, body mass index, quality of life, dietary adherence and acceptability] for people with chronic kidney disease stages 3a-5 were included. Meta-analyses were performed by pooling post-intervention data using random-effects models and inverse variance methods to determine the pooled mean difference or standardised mean difference and 95% confidence intervals.

Results

Eight trials (n = 1204 participants) were included. There was low certainty evidence from five trials (n = 462 participants) that dietitian-delivered nutrition education may result in little to no difference in estimated glomerular filtration rate and body mass index, but large improvements in quality of life compared to usual care (standardised mean differences 0.99, 95% CI -0.31 to 2.29). There was high certainty evidence from 4 trials (n = 398) that dietitian-delivered education reduced diastolic blood pressure by 4.01 mmHg (95% CI -6.13 to -1.90) and systolic blood pressure by 6.23 mmHg (95% CI -9.24 to -3.23). Exploratory sub-group analyses suggest no differences in individual versus group interventions.

Conclusion

Dietitian-delivered education interventions delivered individually or in groups reduced blood pressure and may improve quality of life but had no impact on estimated glomerular filtration rate or body mass index for people with chronic kidney disease stages 3a-5.