(B) With convenience sampling and/or before-after design
StudyCountryPopulationCare modelIntervention componentsMode of deliveryEvaluation methodsOutcomesMethodological
ScreeningDecision supportPatient education
Barahimi et al 24 Iran131 patientsSelf-learning module discussing kidney disease and its complications (with oral presentation held at start)+PatientsProspective comparisonIn patients electing to undertake e-learning (n=39), eGFR remained stable (within 7 mL/min) versus decline in control group at 6 months. E-learning remained an important predictor of higher eGFR after adjustments for significant differences in two groups (age, education, mean arterial pressure).Low
Cueto-Manzano et al 25 Mexico96 patients with diabetes and early-stage CKD,
two clinics
Patient and PCP education on CKD; formation of patient peer groups; MDC++PCP; nursesProspective comparisonIn patients of MDC (n=39), albuminuria dropped (vs usual care, where albuminuria did not change) over 6 months. No differences in eGFRLow
Fogazzi et al 26 Benin and TogoTwo hospitalsCapacity building for CKD care at hospital level+Lab techBefore-afterImproved laboratory capacity to identify kidney diseaseLow
Garcia-Garcia et al 14 Mexico353 patients with CKD stages 3 and 4Nursing-led MDC with equal time allotted to nurses, physicians, social workers and dietitians++NursesBefore-afterIn patients of MDC (n=353), % with BP control doubled, mean HbA1c dropped, use of ARB increased over median 14 months. Proportion with proteinuria did not change. eGFR declined 3.8 mL/min in patients with and stable in patients without diabetes, respectively.Medium
Katz et al 23 South Africa871 patients in primary care clinics, 16 clinicsScreening and treatment guidelines with referral pathway++PCPs;
Case–controlProportion of patients with uncontrolled BP dropped from 85% to 70% in active clinics (vs no change in control clinics); 98% use of ACEi in persons with diabetes and albuminuria at 3 monthsLow
Mani27 India25 000 rural residentsCommunity-based screening with simplified management protocols++CHWCase–controleGFR<80 mL/min in 0.9% of residents of intervention areas versus in 1.4% of residents of areas receiving standard care (no adjustment for baseline demographics) in cross sectionLow
et al 28
Thailand17 patients with stage 4 CKD,
one clinic
MDC and dietary intervention++Nephrologists; dietitianProspective follow-upIn the described group (n=17), mean 24 hours urine declined slightly (from 1 to 0.8 g), mean eGFR within 0.6 mL/min of baseline over 48 months.Low
Zhang et al 29 China300 patients, one clinicMDC, including dietitian and nursing-led education++Nephrologists; nursesBefore-afterUnable to establish feasibility due to high patient dropout with limited follow-upLow
  • ACEi, ACE inhibitors; ARB, angiotensin II receptor blockers; HR: hazard ratio; BP, blood pressure; CHW, community health worker; CKD, chronic kidney disease; Cr, creatinine; CV, cardiovascular; eGFR, estimated glomerular filtration rate (in mL/min/1.73 m2); ESRD, end-stage renal disease; MDC, multidisciplinary care; PCP, primary care provider; RCT, randomised controlled trial; SF-12, 12-Item Short Form Health Survey.