ABSTRACT
Background
Dietary modification is a crucial component of chronic kidney disease (CKD) management, but the complexity of renal diets leads to significant adherence challenges. Understanding the patient’s perspective is vital for developing effective, patient-centred interventions that improve adherence and health outcomes.
Objectives
This scoping review aimed to map the available evidence on the reported preferences of patients with CKD regarding nutrition-related health outcomes, and to identify the perceived barriers and facilitators that hinder or support the achievement of these outcomes.
Eligibility Criteria
Studies were included if they involved adult patients with CKD and explored their perspectives on nutrition-related outcomes, barriers, or facilitators to dietary management. Qualitative, quantitative, and mixed-methods studies published in English were eligible.
Sources of Evidence
A systematic search was conducted in June 2025 across four electronic databases (MEDLINE, CINAHL, Embase, and Cochrane Database of Systematic Reviews), supplemented by hand-searching reference lists of included articles.
Charting Methods
Data were extracted independently using a custom data extraction tool. The identified barriers and facilitators were thematically mapped and categorised according to the World Health Organization Multidimensional Adherence Model (WHO-MAM).
Results
Four studies met the inclusion criteria. A primary finding was the lack of evidence directly addressing patients’ preferred nutrition-related health outcomes. However, preferences could be inferred; patients value reassurance, emotional support, and receiving practical, individualised, and culturally relevant advice. Perceived barriers included: (A) unhelpful, paternalistic communication from healthcare teams; (B) patient factors like feeling overwhelmed and confused; (C) socioeconomic factors such as conflicting cultural norms and social pressures; and (D) therapy-related factors like generic, non-culturally specific advice. Key facilitators included: (A) helpful, empathetic, and collaborative communication styles; (B) patient factors like self-monitoring and psychosocial support; (C) socioeconomic factors such as leveraging cultural health beliefs; and (D) therapy-related factors like health literacy-sensitive materials and dietitian support.
Conclusions
There is a significant gap in the literature regarding the nutrition-related health outcomes that CKD patients prioritise. The findings highlight that the patient–healthcare provider relationship is a pivotal factor influencing adherence. Clinical practice should shift towards a more patient-centred, collaborative, and culturally sensitive model of care. Future research should use qualitative methods to directly investigate patient preferences to inform the co-design of effective dietary interventions.
Journal of Human Nutrition and Dietetics, Volume 39, Issue 3, June 2026. Read More