Nutritional Self-management of Chronic Kidney Disease: A Systematic Review and Co-created Qualitative Synthesis

Andrew Morris; Riya Patel; Konstantinos  Papadopoulos; Berenice  Mahoney; Rebecca  Stack; Eleanor  Bradley; Amy  Neary; Deborah Lycett; Fez Awan; Anne  Foster; Lina  Johansson; Pat Booth; Emma Murphy; Derek  Kyte

doi:10.1053/j.jrn.2025.10.007

Nutritional Self-management of Chronic Kidney Disease: A Systematic Review and Co-created Qualitative Synthesis

Andrew Morris
, Riya Patel
, Konstantinos Papadopoulos
, Berenice Mahoney
, Rebecca Stack
, Eleanor Bradley
, Amy Neary
, Deborah Lycett
, Fez Awan
, Anne Foster
, Lina Johansson
, Pat Booth
, Emma Murphy
, Derek Kyte

Health and Wellbeing Honorary and Visiting Researchers

Worcestershire Acute Hospitals NHS Trust
Leicester General Hospital
University of Worcester
Imperial College Healthcare NHS Trust
University Hospitals Coventry and Warwickshire NHS Trust

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Rationale & Objective Effective nutritional self-management is essential to reducing the risk of morbidity and mortality in chronic kidney disease (CKD). However, the most effective approach for delivering dietary interventions and supporting behavioural change remains uncertain. To inform future service delivery, a systematic qualitative evidence synthesis was conducted to understand patients’ experiences of their nutritional self-management of CKD. Study Design Systematic review. Setting & Study Populations Adults with CKD stages 1-5. Search Strategy & Sources MEDLINE, PsychInfo, and CINALH were searched from inception to 3 July 2023. Google Scholar and Web of Science were used for citation searching. Data Extraction All qualitative results from primary qualitative and mixed-method studies. Analytical Approach Thematic synthesis. Results Ninety-two studies involving 2,924 adults met the inclusion criteria across all stages. Studies reported experiences of multiple stages and modalities of treatment of CKD in 23 countries. Three themes and 8 sub-themes were identified related to nutritional self-management: navigating dietary advice (receiving advice, quality of advice, tailoring of advice), living a new life (mourning an old life, trial and error, enough is enough (re)gaining control) and diet as a social construct (social influences over management, stigma and isolation). Nutritional self-management in CKD is complex and multifaceted. Patients face significant problems in navigating dietary advice, adjusting to lifestyle changes, and managing social influences. Limitations Non-English language studies were excluded. Conclusions Adults living with CKD commonly face considerable challenges around dietary self-management across all stages of CKD and all modalities in stage 5. Incorporating dietary advice is highly complex, and current dietary service delivery often does not adequately meet patients' needs, regardless of their geographical location, stage of CKD, or treatment modality.

Original language	English
Pages (from-to)	261-276
Journal	Journal of Renal Nutrition
Volume	36
Issue number	2
DOIs	https://doi.org/10.1053/j.jrn.2025.10.007
Publication status	Published - 24 Oct 2025

Bibliographical note

Publisher Copyright:
© 2025 by the National Kidney Foundation, Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

This document is the author’s Accepted Manuscript, incorporating any revisions agreed during the peer-review process. Some differences between the published version and this version may remain and you are advised to consult the published version if you wish to cite from it.

Funding

Support: A.M. undertook this study while he received financial support from an NIHR Research Delivery Network West Midlands Clinical Scholarship . The NIHR had no influence over the study design; collection, analysis, and interpretation of data; writing the article; and the decision to submit the report for publication.

Keywords

co-creation
diet
kidney disease
meta-synthesis
patient involvement

Access to Document

10.1053/j.jrn.2025.10.007

Cite this

Morris, A., Patel, R., Papadopoulos , K., Mahoney , B., Stack , R., Bradley , E., Neary , A., Lycett, D., Awan, F., Foster, A., Johansson, L., Booth, P., Murphy, E., & Kyte , D. (2025). Nutritional Self-management of Chronic Kidney Disease: A Systematic Review and Co-created Qualitative Synthesis. Journal of Renal Nutrition, 36(2), 261-276. https://doi.org/10.1053/j.jrn.2025.10.007

Morris, A, Patel, R, Papadopoulos , K, Mahoney , B, Stack , R, Bradley , E, Neary , A, Lycett, D, Awan, F, Foster, A, Johansson, L, Booth, P, Murphy, E & Kyte , D 2025, 'Nutritional Self-management of Chronic Kidney Disease: A Systematic Review and Co-created Qualitative Synthesis', Journal of Renal Nutrition, vol. 36, no. 2, pp. 261-276. https://doi.org/10.1053/j.jrn.2025.10.007

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abstract = "Rationale \& Objective Effective nutritional self-management is essential to reducing the risk of morbidity and mortality in chronic kidney disease (CKD). However, the most effective approach for delivering dietary interventions and supporting behavioural change remains uncertain. To inform future service delivery, a systematic qualitative evidence synthesis was conducted to understand patients{\textquoteright} experiences of their nutritional self-management of CKD. Study Design Systematic review. Setting \& Study Populations Adults with CKD stages 1-5. Search Strategy \& Sources MEDLINE, PsychInfo, and CINALH were searched from inception to 3 July 2023. Google Scholar and Web of Science were used for citation searching. Data Extraction All qualitative results from primary qualitative and mixed-method studies. Analytical Approach Thematic synthesis. Results Ninety-two studies involving 2,924 adults met the inclusion criteria across all stages. Studies reported experiences of multiple stages and modalities of treatment of CKD in 23 countries. Three themes and 8 sub-themes were identified related to nutritional self-management: navigating dietary advice (receiving advice, quality of advice, tailoring of advice), living a new life (mourning an old life, trial and error, enough is enough (re)gaining control) and diet as a social construct (social influences over management, stigma and isolation). Nutritional self-management in CKD is complex and multifaceted. Patients face significant problems in navigating dietary advice, adjusting to lifestyle changes, and managing social influences. Limitations Non-English language studies were excluded. Conclusions Adults living with CKD commonly face considerable challenges around dietary self-management across all stages of CKD and all modalities in stage 5. Incorporating dietary advice is highly complex, and current dietary service delivery often does not adequately meet patients' needs, regardless of their geographical location, stage of CKD, or treatment modality.",

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AU - Mahoney , Berenice

AU - Stack , Rebecca

AU - Bradley , Eleanor

AU - Neary , Amy

AU - Lycett, Deborah

AU - Awan, Fez

AU - Foster, Anne

AU - Johansson, Lina

AU - Booth, Pat

AU - Murphy, Emma

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N2 - Rationale & Objective Effective nutritional self-management is essential to reducing the risk of morbidity and mortality in chronic kidney disease (CKD). However, the most effective approach for delivering dietary interventions and supporting behavioural change remains uncertain. To inform future service delivery, a systematic qualitative evidence synthesis was conducted to understand patients’ experiences of their nutritional self-management of CKD. Study Design Systematic review. Setting & Study Populations Adults with CKD stages 1-5. Search Strategy & Sources MEDLINE, PsychInfo, and CINALH were searched from inception to 3 July 2023. Google Scholar and Web of Science were used for citation searching. Data Extraction All qualitative results from primary qualitative and mixed-method studies. Analytical Approach Thematic synthesis. Results Ninety-two studies involving 2,924 adults met the inclusion criteria across all stages. Studies reported experiences of multiple stages and modalities of treatment of CKD in 23 countries. Three themes and 8 sub-themes were identified related to nutritional self-management: navigating dietary advice (receiving advice, quality of advice, tailoring of advice), living a new life (mourning an old life, trial and error, enough is enough (re)gaining control) and diet as a social construct (social influences over management, stigma and isolation). Nutritional self-management in CKD is complex and multifaceted. Patients face significant problems in navigating dietary advice, adjusting to lifestyle changes, and managing social influences. Limitations Non-English language studies were excluded. Conclusions Adults living with CKD commonly face considerable challenges around dietary self-management across all stages of CKD and all modalities in stage 5. Incorporating dietary advice is highly complex, and current dietary service delivery often does not adequately meet patients' needs, regardless of their geographical location, stage of CKD, or treatment modality.

AB - Rationale & Objective Effective nutritional self-management is essential to reducing the risk of morbidity and mortality in chronic kidney disease (CKD). However, the most effective approach for delivering dietary interventions and supporting behavioural change remains uncertain. To inform future service delivery, a systematic qualitative evidence synthesis was conducted to understand patients’ experiences of their nutritional self-management of CKD. Study Design Systematic review. Setting & Study Populations Adults with CKD stages 1-5. Search Strategy & Sources MEDLINE, PsychInfo, and CINALH were searched from inception to 3 July 2023. Google Scholar and Web of Science were used for citation searching. Data Extraction All qualitative results from primary qualitative and mixed-method studies. Analytical Approach Thematic synthesis. Results Ninety-two studies involving 2,924 adults met the inclusion criteria across all stages. Studies reported experiences of multiple stages and modalities of treatment of CKD in 23 countries. Three themes and 8 sub-themes were identified related to nutritional self-management: navigating dietary advice (receiving advice, quality of advice, tailoring of advice), living a new life (mourning an old life, trial and error, enough is enough (re)gaining control) and diet as a social construct (social influences over management, stigma and isolation). Nutritional self-management in CKD is complex and multifaceted. Patients face significant problems in navigating dietary advice, adjusting to lifestyle changes, and managing social influences. Limitations Non-English language studies were excluded. Conclusions Adults living with CKD commonly face considerable challenges around dietary self-management across all stages of CKD and all modalities in stage 5. Incorporating dietary advice is highly complex, and current dietary service delivery often does not adequately meet patients' needs, regardless of their geographical location, stage of CKD, or treatment modality.

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Nutritional Self-management of Chronic Kidney Disease: A Systematic Review and Co-created Qualitative Synthesis

Abstract

Bibliographical note

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Keywords

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