An umbrella review of 16 systematic reviews and meta-analyses across predialysis, dialysis and transplant populations found more consistent benefits for adherence, diet and fluid management, self-efficacy, psychological well-being and quality of life. Effects on eGFR, biochemistry, hospitalization and long-term morbidity remained heterogeneous or inconclusive.
Key findings
- Benefits were more consistent for medication and dialysis adherence, diet and fluid management, self-efficacy, psychological well-being and quality of life. Multicomponent reminders, interactive education, gamification and personalized feedback appeared engaging, while eGFR, biochemical, hospitalization and long-term outcomes were heterogeneous. Evidence quality was low to moderate.
Why this matters globally
CKD requires sustained self-management worldwide. The review supports evaluating digital tools as service components connected to care teams, with attention to access, equity and long-term outcomes rather than as isolated products.
Thai researcher contribution
Khon Kaen University nursing researchers collaborated with Chinese partners to synthesize high-level evidence across the CKD continuum and foreground implementation questions.
Limitations to consider
Umbrella reviews can double-count primary studies and inherit their biases. English-only evidence varied widely in populations, technologies, intensity, follow-up and outcomes, preventing identification of a best tool; proximal improvements do not guarantee long-term clinical benefit.