Table 3.
Characteristics of the Included Studies Assessing the Effect of Dietary Lifestyle Interventions on CKD Progression
| Study, Country | Sample Size (for Analysis) | Age (y) | BMI (kg/m2) | CKD Stage | Comorbid Conditions | Design | Study Duration (wk)a | |
|---|---|---|---|---|---|---|---|---|
| Caldiroli (2022), Italy46 | 27 | 81 ± 6b | 27.3 ± 6.5b | eGFR: >10 to <30 ml/min/1.73 2 | Diabetes (40%), HT (94%), and previous cardiovascular events (46%) | P | 24 | |
| Campbell (2008), Australia47 | 47 | C: 68.5 ± 12.0; I: 71.0 ± 12.3 | C: 27.0 ± 4.9; I: 27.4 ± 5.3 | 4-5 | NR | P | 12 | |
| Chilelli (2015), Italy48 | 26 | C: 65.2 ± 8.3; I: 64.3 ± 15.6 | C: 25.28 ± 1.14; I: 24.86 ± 0.67 | 3-4 | NR | P | 12 | |
| Clark (2013), Canada49,c | 28 | C: 67 ± 11; I: 59 ± 14 | C: 30 ± 6; I: 31 ± 6 | 3 | Hypertension—C: 100%, I: 77%; Hyperlipidemia—C: 73%, I: 53%; Diabetes—C 64%, I: 47% | P | 6 | |
| de Brito-Ashurst (2013), UK50 | 48 | C: 60.7 ± 12.0; I: 55.7 ± 15.1 | C: 27.1 ± 5.2; I: 26.6 ± 5.4 | Moderate to severe: eGFR < 60 mL/min/1.73 m2 | Mean BP >130/80 mm Hg | P | 24 | |
| Facchini (2003), United States51 | 170 | C: 60 ± 12; I: 59 ± 10 | C: 28 ± 5; I: 28 ± 5 | Various degrees of kidney failure (GFR, 15-75 ml/min/1.73 m2) and unexplained proteinuria | T2DM | P | Mean follow-up: 3.9 y | |
| Goraya (2014)/Goraya (2019), United States52,53 | 72d; 66e,f | C: 53.9 ± 4.8; I: 53.5 ± 5.2 | C: 28.2 ± 2.1; I: 28.8 ± 2.1 | 3 | HT | P | 60 me; 36 mod | |
| Hamidianshirazi (2022), Iran54 | 105 | C: 49.4 (1.8); I: 50.1 (1.9)b,g | C: 26.7 (0.6); I: 26 (0.6)b,g | 3-4 | Participants did not present with diabetes, cancer, or heart failure | P | 24 | |
| Hwang (2014), South Korea55 | 245 | 49.5 ± 13.3 | 67.8 ± 13.5h,i | eGFR ≥ 30 ml/min per 1.73 m2 | HT | Parallel | 8 | |
| Ihle (1989), Australia56 | 64 | C: 36.8 ± 4.8; I: 37.2 ± 5.7 | NR | Serum creatinine concentrations between 350 and 1,000 μmol/L | NR | P | 18 mo | |
| Kankarn (2019a), Thailand57 | 172 | C: 69.24 ± 7.70; I: 70.16 ± 8.79 | C: 25.34 ± 25.34; I: 25.31 ± 3.77 | 3-4 | Diabetes (10.5%), HT (25%), diabetes with HT (47.1%) | P (cluster) | 12 mo | |
| Kelly (2020), Australia58 | 76 | C: 61 ± 13; I: 63 ± 12 | C: 31 ± 6; I: 33 ± 7 | 3-4 | Diabetes (38.8%), CVD (32.5%), HT (81.3%) | P | 24 | |
| Martínez-Villaescusa (2022), Spain59 | 57 | 56.9b | C: 27.9; I: 26.3 | 4-5 | HT (94.7%), dyslipidemia (81.3%), diabetes (25.3%), peripheral vascular disease (10.7%), cerebrovascular disease (1.3%), and ischemic heart disease (10.7%) | P | 12 mo | |
| MDRD (Tangri (2011)/Kopple (1997), United States60,61 | 553d; 302i | C: 52.5 ± 12.2; I: 51.8 ± 12.1 | NR | eGFR: 25 to 55 mL/min/1.73 m2 | T2DM (3%) | P | 2 y | |
| Mekki (2010), Algeria62 | 40 | 61 ± 14 | 26.2 ± 5.6 | Moderate CKD (eGFR, 60-89 mL/min/1.73 m2) | Dyslipidemia | P | 12 | |
| Meloni (2002), Italy63 | 69 | 54.4 ± 15.3 | NR | NR, diabetic nephropathy | T1DM (45%), T2DM (54%), and HT (100%) | P | 12 mo | |
| Meloni (2004), Italy64 | 169 | 57.4 ± 17.8 | NR | NR (n = 80 with diabetic nephropathy) | T1DM (14%), T2DM (33%), and HT (100%) | P | 12 mo | |
| Moe (2011), United States65 | 8 | 61 ± 8.4 | 32 ± 5 | 3-4 | Diabetes (50%) and HT (75%) | X | 1 | |
| Mozaffari-Rad (2022), Iran66 | 71 | C: 63.51 ± 9.34; I: 53.87 ± 13.98 | C: 29.94 ± 5.64; I: 27.64 ± 4.82 | Protein to creatinine ratio >30 mg/g in a random urine sample and an eGFR >15 mL/min/1.73 m2 (eGFR range: 14.7-91.8 mL/min/1.73 m2) | Diabetes (49.2%) and HT (31%) | P | 8 | |
| Paes-Barreto (2013), Brazil67 | 89 | 63.4 ± 40.8 | C: 28.3 ± 5.3; I: 28.9 ± 5.6 | 3-5 | Diabetes (42.7%) and HT (92%) | P | 16 | |
| Sánchez (2009), Spain68 | 40 | 54 ± 13 | C: 28.20 ± 7.06; I: 27.38 ± 5.4 | Serum creatinine concentration >25 mg/dL | NR | P | 12 mo | |
| Saran (2017), United States69 | 58 | 61j | NR | 3-4 | Diabetes (43%) and HT (93%) | X | 4 | |
| Slagman (2011), Netherlands70 | 52 | Treatment sequence 1: 53 (3); treatment sequence 2: 55 (3); treatment sequence 3: 51 (4); treatment sequence 4: 47 (4)g | Treatment sequence 1: 27 (1); treatment sequence 2: 28 (1); treatment sequence 3: 28 (1); treatment sequence 4: 28 (1)g | NR | Nondiabetic nephropathy | X | 6 | |
| Soroka (1998), Israel71 | 9 | 30-85k | NR | creatinine clearance between 15 and 50 mL/min per 1.73 m2 | HT | X | 24 | |
| Turban (2021), United States72 | 25 | 67.2 ± 11.6b | 31.4 ± 4.7b | 3 | Medication for: diabetes (24.1%), HT (93.1%)b | X | 4 | |
Abbreviations: BMI, body mass index; C, control; HT, hypertension; I, intervention; MDRD, Modification of Diet in Renal Disease; NR, not reported; P, parallel; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus; X, crossover.
a
Duration reported in weeks (using 4 wk/mo) for duration of <12 months and reported as months/years for duration of 12 months and more.
b
Characteristics reported for randomly assigned participants.
c
Study intervention was hydration related, not diet related.
d
For body weight.
e
For eGFR and systolic blood pressure.
f
Study included other intervention group(s), which was not relevant to this review; therefore, this group(s) was not included in this analysis.
g
Mean (standard error).
h
Body weight (kg) is reported when BMI was not available.
i
For GFR, creatinine, body weight, and HbA1c.
j
Mean.
k
Range.