Abstract: SA-PO1187
Effectiveness of Multicomponent Interventions in Delaying Disease Progression in Patients with Stage 3-4 CKD: Systematic Review and Meta-Analysis
Session Information
- CKD: Biomarkers and Emerging Tools for Diagnosis and Monitoring
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Ma, Chenxinan, Duke-NUS Medical School Programme in Health Services and Systems Research, Singapore, Singapore
- Wu, Lei, Duke Kunshan University Global Health Program, Suzhou, Jiangsu, China
- Li, Yaxi, Alice Lee Centre for Nursing Studies, Singapore, Singapore
- Yang, Bolu, Wuhan University, Wuhan, Hubei, China
- Tan, Jie, Wuhan University, Wuhan, Hubei, China
- Liu, Sibo, Duke-NUS Medical School Programme in Health Services and Systems Research, Singapore, Singapore
- Jafar, Tazeen H., Duke-NUS Medical School Programme in Health Services and Systems Research, Singapore, Singapore
Background
Various multicomponent interventions (MCIs) incorporating different evidence-based approaches have been developed for chronic kidney disease (CKD) patients, but they have not been systematically evaluated. Hence, we aimed to assess the effectiveness of MCIs in delaying CKD progression among patients with stage 3-4 CKD.
Methods
PubMed, Embase, Cochrane CENTRAL, Web of Science, and CINAHL databases were searched for relevant studies published from inception to 3 September 2024. We included randomized controlled trials (≥6 months) that compared MCIs with usual care or less intensive MCIs and reported estimated glomerular filtration rate (eGFR) outcomes in patients with stage 3-4 CKD. Random-effects meta-analyses were used to synthesize effect estimates across studies.
Results
Nineteen RCTs involving 36,411 stage 3-4 CKD patients were included. Most MCIs delivered holistic CKD care targeting multiple risk factors and typically involved multidisciplinary care teams. Compared to control, MCIs were associated with modest improvements in eGFR (mean difference [MD]: 1.30 ml/min/1.73 m2; 95% CI: 0.26 to 2.35). Six studies reported annual eGFR decline, with a pooled effect showing a significantly slower decline in the MCI group relative to control (MD: 0.73 ml/min/1.73 m2/year; 95% CI: 0.08 to 1.38).
Conclusion
Our findings support the potential role of holistic MCIs in delaying progression in patients with stage 3-4 CKD. Further high-quality studies are needed to confirm this effect of MCIs on slowing CKD progression.
Fig 1. eGFR
Fig 2. Annual eGFR decline