Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 22;8(3):e019814.
doi: 10.1136/bmjopen-2017-019814.

Self-management interventions for adults with chronic kidney disease: a scoping review

Maoliosa Donald  1   2   3 , Bhavneet Kaur Kahlon  3 , Heather Beanlands  4 , Sharon Straus  5   6 , Paul Ronksley  2   3 , Gwen Herrington  7 , Allison Tong  8 , Allan Grill  9 , Blair Waldvogel  7 , Chantel A Large  7 , Claire L Large  7 , Lori Harwood  10 , Marta Novak  11   12 , Matthew T James  1   2   3 , Meghan Elliott  6 , Nicolas Fernandez  7 , Scott Brimble  13 , Susan Samuel  14 , Brenda R Hemmelgarn  1   2   3
Affiliations

Self-management interventions for adults with chronic kidney disease: a scoping review

Maoliosa Donald et al. BMJ Open. .

Abstract

Objective: To systematically identify and describe self-management interventions for adult patients with chronic kidney disease (CKD).

Setting: Community-based.

Participants: Adults with CKD stages 1-5 (not requiring kidney replacement therapy).

Interventions: Self-management strategies for adults with CKD.

Primary and secondary outcome measures: Using a scoping review, electronic databases and grey literature were searched in October 2016 to identify self-management interventions for adults with CKD stages 1-5 (not requiring kidney replacement therapy). Randomised controlled trials (RCTs), non-RCTs, qualitative and mixed method studies were included and study selection and data extraction were independently performed by two reviewers. Outcomes included behaviours, cognitions, physiological measures, symptoms, health status and healthcare.

Results: Fifty studies (19 RCTs, 7 quasi-experimental, 5 observational, 13 pre-post intervention, 1 mixed method and 5 qualitative) reporting 45 interventions were included. The most common intervention topic was diet/nutrition and interventions were regularly delivered face to face. Interventions were administered by a variety of providers, with nursing professionals the most common health professional group. Cognitions (ie, changes in general CKD knowledge, perceived self-management and motivation) were the most frequently reported outcome domain that showed improvement. Less than 1% of the interventions were co-developed with patients and 20% were based on a theory or framework.

Conclusions: There was a wide range of self-management interventions with considerable variability in outcomes for adults with CKD. Major gaps in the literature include lack of patient engagement in the design of the interventions, with the majority of interventions not applying a behavioural change theory to inform their development. This work highlights the need to involve patients to co-developed and evaluate a self-management intervention based on sound theories and clinical evidence.

Keywords: chronic kidney disease; person centered-care; scoping review; self-management.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Prisma flow diagram.
See this image and copyright information in PMC

References

    1. Arora P, Vasa P, Brenner D, et al. Prevalence estimates of chronic kidney disease in Canada: results of a nationally representative survey. CMAJ 2013;185:e417–23. 10.1503/cmaj.120833 - DOI - PMC - PubMed
    1. Tonelli M, Wiebe N, Guthrie B, et al. Comorbidity as a driver of adverse outcomes in people with chronic kidney disease. Kidney Int 2015;88:859–66. 10.1038/ki.2015.228 - DOI - PubMed
    1. Hemmelgarn BR, Pannu N, Ahmed SB, et al. Determining the research priorities for patients with chronic kidney disease not on dialysis. Nephrology, dialysis . Transplantation 2017;32:847–54. - PMC - PubMed
    1. Tong A, Chando S, Crowe S, et al. Research priority setting in kidney disease: a systematic review. American Journal of Kidney Diseases 2015;65:674–83. - PubMed
    1. Richard AA, Shea K. Delineation of self-care and associated concepts. J Nurs Scholarsh 2011;43:no–64. 10.1111/j.1547-5069.2011.01404.x - DOI - PubMed

Publication types

Grants and funding