BACKGROUND: Dietary modification is a crucial component of chronic kidney disease (CKD) management, but the complexity of renal diets leads to significant adherence challenges. Understanding the patient's perspective is vital for developing effective, patient-centred interventions that improve adherence and health outcomes. OBJECTIVES: This scoping review aimed to map the available evidence on the reported preferences of patients with CKD regarding nutrition-related health outcomes, and to identify the perceived barriers and facilitators that hinder or support the achievement of these outcomes. ELIGIBILITY CRITERIA: Studies were included if they involved adult patients with CKD and explored their perspectives on nutrition-related outcomes, barriers, or facilitators to dietary management. Qualitative, quantitative, and mixed-methods studies published in English were eligible. SOURCES OF EVIDENCE: A systematic search was conducted in June 2025 across four electronic databases (MEDLINE, CINAHL, Embase, and Cochrane Database of Systematic Reviews), supplemented by hand-searching reference lists of included articles. CHARTING METHODS: Data were extracted independently using a custom data extraction tool. The identified barriers and facilitators were thematically mapped and categorised according to the World Health Organization Multidimensional Adherence Model (WHO-MAM). RESULTS: Four studies met the inclusion criteria. A primary finding was the lack of evidence directly addressing patients' preferred nutrition-related health outcomes. However, preferences could be inferred; patients value reassurance, emotional support, and receiving practical, individualised, and culturally relevant advice. Perceived barriers included: (A) unhelpful, paternalistic communication from healthcare teams; (B) patient factors like feeling overwhelmed and confused; (C) socioeconomic factors such as conflicting cultural norms and social pressures; and (D) therapy-related factors like generic, non-culturally specific advice. Key facilitators included: (A) helpful, empathetic, and collaborative communication styles; (B) patient factors like self-monitoring and psychosocial support; (C) socioeconomic factors such as leveraging cultural health beliefs; and (D) therapy-related factors like health literacy-sensitive materials and dietitian support. CONCLUSIONS: There is a significant gap in the literature regarding the nutrition-related health outcomes that CKD patients prioritise. The findings highlight that the patient-healthcare provider relationship is a pivotal factor influencing adherence. Clinical practice should shift towards a more patient-centred, collaborative, and culturally sensitive model of care. Future research should use qualitative methods to directly investigate patient preferences to inform the co-design of effective dietary interventions.
Karami et al. (Sun,) studied this question.
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