Effectiveness of mHealth Nutrition Interventions on Nutrition-Related and Clinical Outcomes in Adults with Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

BACKGROUND/OBJECTIVES: Diet recommendations for individuals with chronic kidney disease (CKD) are complex and can be challenging to integrate into daily routines. Mobile health (mHealth) interventions may support dietary education, self-monitoring, and disease management; however, their effects on nutrition-related and clinical outcomes in CKD remain unclear. This systematic review and meta-analysis evaluated the effectiveness of mHealth interventions on nutrition-related and clinical outcomes among adults with CKD. METHODS: The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Five databases were searched from inception through February 2026. Controlled trials, quasi-experimental designs and pre-post studies evaluating mHealth interventions and reporting nutrition-related and/or clinical outcomes were eligible for inclusion. Randomized controlled trials and controlled quasi-experimental studies with comparable outcomes and sufficient data were included in the quantitative synthesis. Pre-post studies were synthesized narratively because changes from baseline could not be distinguished from temporal effects in the absence of a concurrent comparator. Risk of bias was assessed using the Cochrane Risk of Bias tool and ROBINS-I. RESULTS: Twenty-three studies were included in the review, with eight meeting the inclusion criteria for a meta-analysis. Among the quantitative synthesis of adults on dialysis, no significant effects were shown with biochemical outcomes or interdialytic weight gain. Several pre-post studies reported within-study improvements in dietary intake, including sodium intake, and blood pressure outcomes. These findings should be interpreted cautiously because the absence of a concurrent control group precludes attributing observed changes specifically to the mHealth intervention. CONCLUSIONS: mHealth interventions may support improvements in selected dietary and clinical outcomes among adults with CKD; however, evidence from randomized controlled trials remains limited. Improvements reported in pre/post studies should be interpreted cautiously and additional well-designed randomized controlled trials are needed to determine their effectiveness across CKD populations.