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The effect of nutrition education interventions on dialysis patients' outcomes: a systematic review and meta-analysis.

Sogand Sarmadi·Neda Sanaie·Akbar Zare-Kaseb
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Abstract

BACKGROUND: Non-adherence to dietary and fluid restrictions among dialysis patients is associated with adverse clinical outcomes. Quantifying the effectiveness of nutrition education interventions can inform practice and policy. METHODS: We searched MEDLINE, EMBASE, CINAHL, CENTRAL, PsycINFO, Web of Science, and Scopus up to 15 July 2025, supplemented by trial registries and Google Scholar, with an updated search through 8 April 2026. Eligible studies included randomized and non-randomized trials evaluating nutritional education interventions in adult dialysis populations. Risk of bias was assessed using RoB-2 and ROBINS-I, certainty graded using GRADE, and random-effects meta-analyses conducted alongside subgroup, sensitivity, and meta-regression analyses. Publication bias was assessed with Egger and Begg tests and trim-and-fill where applicable. RESULTS: Forty-four studies comprising 4,106 participants were included. Nutrition education significantly improved knowledge (SMD = 1.09; 95% CI: 0.67-1.51) and health-related quality of life (SMD = 1.43; 95% CI: 0.86-2.00; I² = 0%), and reduced serum potassium (SMD = -0.52; 95% CI: -0.91 to -0.14; I² = 92%) and serum phosphate (SMD = -0.35; 95% CI: -0.56 to -0.15; I² = 81%). Results for albumin, creatinine, sodium, calcium, and BUN were inconsistent and non-significant. Most outcomes were rated low or very low certainty by GRADE, reflecting inconsistency, indirectness, and imprecision. Potential publication bias was identified for certain outcomes. CONCLUSIONS: Nutrition education consistently improves knowledge and quality of life and may modestly reduce serum phosphate and potassium in dialysis patients. High-quality registered trials with standardized outcomes and longer follow-up are needed to establish effectiveness and sustainability. PROSPERO REGISTRATION: CRD420251119567.

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HumansRenal DialysisPatient Education as TopicQuality of LifePotassiumKidney Failure, ChronicHealth Knowledge, Attitudes, PracticePatient ComplianceNutrition educationdialysisdietary adherencehemodialysismeta-analysispatient knowledgequality of lifeserum phosphateserum potassiumsystematic reviewJournal ArticleSystematic ReviewMeta-AnalysisResearch Support, Non-U.S. Gov't

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Sogand Sarmadi, Neda Sanaie, Akbar Zare-Kaseb. 2026-04-22. The effect of nutrition education interventions on dialysis patients' outcomes: a systematic review and meta-analysis.. https://doi.org/10.1080/07853890.2026.2660389

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Health Knowledge, Attitudes, Practice subjectHumans subjectJournal Article subjectJournal Article; Systematic Review; Meta-Analysis; Research Support, Non-U.S. Gov't resourceKidney Failure, Chronic subjectMeta-Analysis subjectNutrition education subjectPatient Compliance subjectPatient Education as Topic subjectSystematic reviews studydialysis subjectdietary adherence subjecthemodialysis subjectpatient knowledge subject

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