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Randomized Controlled Trial
. 2022 Aug 10;23(1):280.
doi: 10.1186/s12882-022-02885-6.

Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults

McKenzie K Roddy  1 , Lindsay S Mayberry  2 , Devika Nair  3 , Kerri L Cavanaugh  4
Affiliations
Randomized Controlled Trial

Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults

McKenzie K Roddy et al. BMC Nephrol. .

Abstract

Background: Many individuals living with chronic kidney disease (CKD) have comorbid Type 2 diabetes (T2D). We sought to explore if efficacious interventions that improve glycemic control may also have potential to reduce CKD progression.

Methods: REACH is a text message-delivered self-management support intervention, which focused on medication adherence, diet, and exercise that significantly improved glycemic control in N = 506 patients with T2D. Using data from the trial, we characterized kidney health in the full sample and explored the intervention's effect on change in estimated glomerular filtration rate (eGFR) at 12 months in a subsample of N=271 patients with eGFR data.

Results: In a diverse sample with respect to race/ethnicity and socioeconomic status, 37.2% had presence of mild or heavy proteinuria and/or an eGFR < 60 mL/min/1.73 m2. There was a trending interaction effect between intervention and presence of proteinuria at baseline (b = 6.016, p = .099) such that patients with proteinuria at baseline who received REACH had less worsening of eGFR.

Conclusions: Future research should examine whether diabetes directed self-management support reduces CKD progression in ethnically diverse individuals with albuminuria. In highly comorbid populations, such as T2D and CKD, text-based support can be further tailored according to individuals' multimorbid disease self-management needs and is readily scalable for individuals with limited resources.

Trial registration: This study was registered with ClinicalTrials.gov ( NCT02409329 ).

Keywords: Chronic kidney disease (CKD); Type 2 diabetes (T2D); mHealth.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Estimated glomerular filtration rate (eGFR) at baseline and 12 months follow-up for REACH and Control separately by no and any albuminuria at baseline. Sample sizes for no albuminuria were NControl = 97 and NREACH = 100; sample sizes for any albuminuria were NControl = 42 and NREACH = 32
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