Effects of Dietary App-Supported Tele-Counseling on Sodium Intake, Diet Quality, and Blood Pressure in Patients With Diabetes and Kidney Disease

OBJECTIVE: To examine the effect of a telehealth intervention that used a dietary app, educational website, and weekly dietitian tele-counseling) on sodium intake, diet quality, blood pressure and albuminuria among individuals with diabetes and early stage chronic kidney disease. DESIGN AND METHODS: We examined the effects of a dietary app-supported tele-counseling intervention in a single center, single arm study of 44 participants with type 2 diabetes and stage 1–3a chronic kidney disease. Participants recorded and shared dietary data via MyFitnessPal with registered dietitians, who used motivational interviewing to provide telephone counseling weekly for 8 weeks. After the 8-week intensive intervention, participants were followed at 6 months and 12 months. Outcomes included 24-hour urine sodium (2 collections per timepoint), Healthy Eating Index (HEI) 2015 score (three 24-hour dietary recalls per timepoint), 24-hour systolic blood pressure (SBP) and diastolic blood pressure (DBP), and 24-hour urine albumin excretion. RESULTS: Out of 44 consented participants (mean age 60.3 +/− 11.9 years, 43% female, 89% white, median eGFR was 78.5 ml/min/1.73m(2), median urine albumin excretion 52.9 mg/day, 84% hypertension), 32 (73%) completed 8-week follow-up, 27 (61%) completed 6-month follow up, and 25 (57%) completed 12-month follow up. Among participants who completed 12-month follow up, reported sodium intake decreased by 638 mg/day from baseline of 2919 mg/day (p-value