SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1681161
The Impact of Digital Health Technology-Based Nutritional Interventions on the Nutritional Status of Hemodialysis Patients: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1China Medical University, Shenyang, China
- 2Shengjing Hospital of China Medical University, Shenyang, China
- 3Shenyang Orthopedics Hospital, Shen Yang, China
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Background: Chronic kidney disease (CKD) imposes a growing global burden, with hemodialysis (HD) patients facing high malnutrition rates (28% ~ 54%). Nutritional management is critical but challenging due to strict dietary restrictions and limited healthcare monitoring. Digital health technologies (DHTs) offer dynamic, personalized interventions, yet their efficacy remains inconsistent. This systematic review and meta-analysis aims to assess the effects of DHTs-based nutritional interventions on the nutritional status of hemodialysis patients. Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Scopus, CNKI, CBM, WanFang, and VIP databases from their inception to March 21, 2025, to investigate the impact of DHTs-based nutritional interventions on the nutritional status of hemodialysis patients. Outcomes included biochemical parameters, anthropometric measures, and Modified Quantitative Subjective Global Assessment (MQSGA). Risk-of-bias assessment used Cochrane criteria, and meta-analyses employed RevMan 5.4 with random/fixed-effects models. Results: A total of 23 literatures were included, involving 6 countries and 2,762 hemodialysis patients. DHT interventions improved MQSGA, hemoglobin, albumin, prealbumin, phosphorus, potassium, BMI, mid-arm muscle circumference, triceps skinfold thickness, relative increase in body weight (%) , weight gain, blood urea nitrogen and serum creatinine, these 13 outcome measures. However, it had no significant effect on transferrin and calcium. The intervention forms are mainly applications and mobile platforms. Conclusion: Overall, DHT-based nutritional interventions effectively enhance multiple nutritional indicators in HD patients. However, variability in study quality, intervention formats, and regional disparities limit generalizability. Future research should prioritize high-quality, multicenter RCTs to optimize intervention protocols and explore emerging technologies. Systematic review registration: This study has been registered in PROSPERO: CRD420251023133.
Keywords: Digital health technology, hemodialysis, nutrition, Meta-analysis, Systematic review
Received: 07 Aug 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Zhang, Cheng, Zhang, Wang, Wei and Ni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cuiping Ni, cpni@cmu.edu.cn
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