Intervention Study ID	Intervention	Comparator	CKD stage	Mean age (years)	Men (%)	Mean BMI (kg/m²)	Length of intervention	Description of intervention and comparator	Primary outcome/s
Comparison 1. Lifestyle Interventions versus usual care or control
Lifestyle Interventions versus usual care or control
Baria 2014	Exercise	Usual care	Stages 3 to 4	52	100	30.4 ± 3.8	12 weeks	Intervention (n =8) Centre based aerobic exercise: 3 x 30 minute walking sessions/week on in centre treadmill, increasing intensity and duration Home based aerobic exercise: 3 x 30 minute walking sessions/week at home, increasing intensity and duration Comparison (n = 9) Usual care: no exercise intervention	Body composition (weight loss, BMI, waist circumference, visceral fat, subcutaneous fat)
Ikizler 2018	Dietary and aerobic exercise	Usual care Dietary Exercise	Stages 3 to 4	60	68	‐	4 months	Intervention x 3 (n = 71) Aerobic exercise + energy restriction (n = 24): supervised aerobic exercise x 3; 30 to 45 minute sessions/week + daily dietary restriction of 300 to 500 kcal OR Usual activity + energy restriction (n = 25): usual activity + daily energy restriction of 300 to 500 kcal OR Aerobic exercise + usual diet (n = 22): supervised aerobic exercise x 3; 30 to 45 minute sessions/week + usual diet Comparison (n = 21) Usual activity + usual diet: advised to continue with usual diet and usual activity	Metabolic risk profile (oxidative stress, inflammation, and body composition (BMI, waist circumference, body fat)
Kittiskulnam 2014	Dietary	Usual care	Stages 1 to 4	45	85	Diet‐group 28.5 ± 4.8 Usual care 28.7 ± 4.8	6 months	Intervention(n = 13) Daily energy restriction of 500 kcal + daily protein target of 0.6 to 0.8 g/kg/day Comparison(n = 13) No energy restriction Usual care: dietary advice to retard CKD progression with goal for protein target of 0.6 to 0.8g/kg/day	Proteinuria, adipokine level, renal function (eGFR, serum creatinine)
LANDMARK 3 2013	Mixed (dietary and exercise and behavioural)	Usual care	Stages 3 to 4	Intervention 60 Control 62	63	Intervention 32.5 ± 6.8 Control 33.0 ± 8.0	12 months	Intervention (n = 36) Lifestyle intervention included multidisciplinary care (including a CKD nurse practitioner, dietitian, exercise physiologist, diabetic educator, psychologist, and social worker), a lifestyle program, and aerobic and resistance exercise training Comparison (n = 36) Usual standard nephrologist care and referral to an allied health professional on an ad hoc basis.	Cardiorespiratory fitness ( peak V02)
Leehey 2009	Exercise	Usual care	Stages 2 to 4	66	100	‐	24 weeks	Intervention (n = 7) Aerobic exercise: 3 x 30 minute walking sessions/week, (6 weeks in‐centre, then 18 weeks at home) increasing intensity and duration Comparison (n = 4) Standard medical care including education for treatment of diabetes and CKD	Proteinuria
Morales 2003a	Dietary	Usual care	CKD stages 1 to 4	56	60	Diet‐group 33 ± 3.5 Usual care 34.3 ± 5.7	5 months	Intervention (n = 20) Daily energy restriction of 500 kcal + daily protein target of 1 to 1.2g/kg/day Comparison (n = 10) No energy restriction. Usual dietary intake with a protein goal of 1 to 1.2g/kg/day	Urinary protein excretion
Orazio 2011	Lifestyle	Usual care	Transplant recipients	55	61	Intervention group 29 ± 5 Control group 29 ± 6	2 years	Intervention (n = 56) Mediterranean style, low glycaemic index diet with a 500 kcal/day energy restriction and encouraged to achieve 150 minutes of accumulated physical activity each week with Health Behaviour Change or stage of Change Model underpinning the lifestyle intervention Comparison (n = 46) Standard usual care	Dietary factors, physical activity, cardiorespiratory fitness, anthropometry, biochemical and clinical factors
Praga 1995	Dietary	Usual care	CKD	48	35	37.9 ± 4.1	12 months	Intervention (n = 9) Energy restricted diet. 1000 to 1400 kcal/day without protein restrictions Comparison (n = 8) No energy restriction, maintained current dietary habits. Commenced captopril treatment (25 to 150 mg/day)	Weight loss, proteinuria
Woolf 2017	Behavioural ‐ Social Cognitive Theory (SCT) based counselling	Usual care	CKD	66	71	34.8 ± 5.4	6 months	Intervention (n = 7) SCT‐based live WebEx sessions with a registered dietitian, access to online tool to log dietary intake, exercise, and body weight and email feedback from a registered dietitian weekly for the first month and then biweekly for 6 months Comparison (n = 7) Standard behaviour management group. No further information on what the group received was reported	Weight loss and self efficacy
Pharmacological Interventions versus usual care or control
Tomlinson 1975 (Trial 2)	Appetite suppressant	Control	Transplant recipients	‐	57	‐	5 to 6 weeks	Intervention (n = 8) Received 80 mg/day fenfluramine for 5 to 6 weeks, then placebo medication for a period of 3 weeks and finally given placebo medication for 5 to 6 weeks Comparison (n = 6) Received placebo for 5 to 6 weeks, then placebo medication for a period of 3 weeks, and finally given 80 mg/day fenfluramine for 5 to 6 weeks	Body weight, plasma lipids
Mixed Interventions versus usual care or control
Teplan 2002	Dietary and appetite suppressant	Control	Transplant recipients	Range 22 to 78	42	‐	3 years	Intervention (n = 128) Individualised low energy and low fat diet + corticoids withdrawal. After 3 months participants were given orlistat at a dose of up to 3 x 120 mg/day and statins for 3 years Comparison (n = 130) Usual care for up to 3 years	BMI, total cholesterol, triglycerides, LDL cholesterol, fasting blood sugar level, creatinine clearance, proteinuria
Comparison 2. Any weight loss intervention versus diet intervention
DIRECT 2013	Dietary	Dietary	Subset data of those with stage 3 to 4 CKD obtained from authors	‐	‐	Low fat diet 30.8 ± 2.89 Mediterranean diet 30.6 ± 4.0 low carbohydrate diet 31.3 ± 3.24	2 years	Intervention 1 (n = 34) Low fat diet: 1500 kcal/day for women and 1800 kcal/day for men, 30% from total fat, 10% from saturated fat Intervention 2 (n = 36) Mediterranean energy restricted: 1500 kcal/day for women and 1800 kcal/day for men, goal no more than 35% of energy from fat, main sources of fat were 30 to 45 g of olive oil and a handful of nuts per day Intervention3 (n = 29) Low carbohydrate, non‐energy restricted: 20 g of carbohydrate/day for 2 months and then gradual increase to a max of 120 g/day	Weight loss
Jesudason 2013	Dietary	Dietary	CKD stage 1, 2 and those with stage 3 with an eGFR > 40	59.4	78	‐	12 months	Intervention 1 (n = 24) Standard protein weight loss diet: 6000 kJ for women and 7000 kJ/day for men, daily protein goal of 90 to 120 g Intervention 2 (n = 21) Moderate protein weight loss diet: 6000 kJ/day for women and 7000 kJ/day for men, daily protein goal of 90 to 120 g	Kidney function (measured GFR)
Leehey 2016	Exercise + dietary	Dietary	CKD stage 2 to 4	66	100	37.0 ± 4.5	12 months	Intervention 1 (n = 18) Exercise + dietary: 12 weeks of thrice weekly exercise training followed by 40 weeks of supervised home exercise + daily 200 to 250 kcal energy restriction and usual medical care Intervention 2 (n = 18) Diet only :daily 200 to 250 kcal energy restriction + usual medical care	Urine protein:creatinine ratio
Teplan 2006	Dietary	Dietary	CKD stage 3 to 4	52	49	Group 1 32.0 ± 3.3 Group 2 31.6 ± 3.9	3 years	Intervention 1 (n = 66) Low protein + energy restriction + keto‐amino acid supplementation: low protein diet 0.6 g/kg/day, energy intake 120 to 125 kJ/kg/day for first 6 months and 125 to 130 kJ/kg/day thereafter. Diet was supplemented with Ketosteril (Fresenius Kabi) at a dose of 100 mg/kg/day Intervention 2 (n = 65) Low protein + energy restriction + placebo: low protein diet 0.6 g/kg/day, energy intake 120 to 125 kJ/kg/day for first 6 months and 125 to 130 kJ/kg/day thereafter. Diet was supplemented with placebo	Plasma asymmetric dimethylarginine levels, body composition (BMI, visceral fat mass)
Tomlinson 1975 (Trial 1)	Appetite suppressant	Dietary	Transplant recipients	‐	55	‐	12 to 15 weeks	Intervention 1 (n = 6) Received placebo medication for 2 to 3 weeks as a run‐in period, then continued on placebo medication for 5 to 6 weeks followed by 120 mg/day fenfluramine for 5 to 6 weeks. Received dietary advice at the beginning and during the run in phase Intervention 2 (n = 5) Received placebo medication for 2 to 3 weeks as a run‐in period, then received 120 mg/day fenfluramine for 5 to 6 weeks followed by placebo medication for 5 to 6 weeks. Received dietary advice at the beginning and during the run in phase	Body weight, plasma lipids
Comparison 3. Surgical intervention versus non‐surgical intervention
MacLaughlin 2014	Surgical (sleeve gastrectomy)	Dietary + pharmacological	CKD 3 to 4	Median age 52	18	Median 39.5	12 months	Intervention (n = 5) Laparoscopic sleeve gastrectomy surgery + dietary energy restriction to ~ 1000 kcal/day post surgery Comparison (n = 6) Best medical care including an individualised dietary and physical activity prescription + orlistat	eGFR, proteinuria, quality of life, insulin resistance, inflammation, adipokine response
Tzvetanov 2015	Surgical (sleeve gastrectomy)	Standard weight loss program	Transplant recipients	Surgical group 45 Standard weight loss group 43	‐	Surgical group 39.9 ± 1.4 Standard weight loss group 40.5 ± 0.2	12 months	Intervention (n = 4) Simultaneous robotic kidney transplant and sleeve gastrectomy Comparison (n = 2) Standard weight loss program after a robotic kidney transplant	BMI, eGFR