Clinical Lead Dietitian publishes new study on Chronic Kidney Disease dietary self-management

Clinical Lead Dietitian publishes new study on Chronic Kidney Disease dietary self-management

The Clinical Lead Dietitian at Worcestershire Acute Hospitals NHS Trust has published one of the largest studies into how people with Chronic Kidney Disease (CKD) experience managing dietary advice in everyday life.

Dr Andrew Morris led the research which brought together evidence from multiple studies to better understand the challenges patients with CKD face.

Dr Morris was awarded the West Midlands National Institute for Health and Care Research’s Health and Care Research Scholarship in 2023 to carry out the study.

The qualitative syntheses highlighted important implications for how dietitians and wider healthcare teams support people with Chronic Kidney Disease.

Below you can read a brief overview of Dr Andrew Morris’ study:

Nutritional Self-Management in Chronic Kidney Disease – What evidence and lived experience tell us

Author: Dr Andrew Morris
Clinical Academic Dietitian (NHS) | Honorary Research Fellow, Coventry University

Why this matters

For people living with chronic kidney disease (CKD), managing diet is a central part of everyday care. Dietary advice is often complex, long-term, and closely linked to clinical risk. Yet many people are expected to manage this largely on their own, with limited ongoing support.

While nutritional self-management is widely promoted in CKD care, less attention has been paid to how people actually experience it in daily life, and how dietary advice affects wellbeing, confidence, and quality of life. Understanding this is essential if dietary care is to support people to live well with CKD, not just manage blood results.

What this research explored

This research brought together qualitative evidence exploring how people with CKD experience nutritional self-management.

A systematic review of qualitative studies was combined with a co-created qualitative synthesis, developed with patient and public contributors. This approach ensured that findings reflected lived experience and patient priorities, rather than focusing solely on adherence or knowledge.

Key findings

Nutritional self-management is ongoing and demanding
People described managing diet as a continuous process rather than a one-off change. Food choices were shaped by symptoms, test results, medications, social situations, emotions, and changing advice over time.

Dietary advice affects everyday life
Food was closely linked to enjoyment, social life, culture, and identity. Dietary restrictions could reduce enjoyment of food, limit social participation, and create feelings of loss or frustration, particularly when advice felt rigid.

Uncertainty is common
Many people felt unsure about which foods were safe, how strictly advice needed to be followed, and how to balance different dietary messages. This uncertainty was often managed alone, through trial and error, which could increase anxiety.

Support makes a difference
Ongoing, personalised support helped people feel more confident and capable. However, many described limited access to dietetic input beyond clinic appointments. People valued support that explained why advice was given and took account of individual priorities.

What this means for kidney care

These findings show that nutritional self-management in CKD is not just about providing information. It is about supporting people to integrate dietary advice into complex, real-world lives.

Effective dietary care should:

• Treat self-management as a shared responsibility, not an individual burden
• Support flexible, person-centred approaches
• Recognise the emotional and social impact of dietary advice
• Provide ongoing support, not just one-off education

Implications for kidney research

This research highlights priorities for future kidney research and funding:

• Broaden outcomes: Go beyond biochemical measures to include quality of life, wellbeing, confidence, and sustainability
• Co-design solutions: Develop dietary self-management interventions with people living with CKD
• Support innovation: Evaluate digital tools, peer support, and new models of supported self-management
• Align guidance with lived experience: Ensure research and guidance reflect the realities of everyday life with CKD

Key messages

• Nutritional self-management is central to living with CKD but can be burdensome without support
• Dietary advice affects wellbeing, confidence, and quality of life, not just health outcomes
• People value personalised, flexible dietary care that acknowledges uncertainty
• Kidney research has a key role in developing better ways to support dietary self-management

About the author

Dr Andrew Morris is a clinical academic dietitian specialising in dietary potassium and nutritional self-management in chronic kidney disease. He works clinically within the NHS and is an Honorary Research Fellow at Coventry University, with a regional leadership role within NIHR-supported renal research networks relevant to Kidney Research UK. His work focuses on integrating evidence, practice, and lived experience to improve renal nutrition care.

If you’d like to read the full publication, you can access it here: 

Nutritional Self-management of Chronic Kidney Disease: A Systematic Review and Co-created Qualitative Synthesis