Effects of Journaling Dietary Intake App on the Health Outcomes of Chronic Kidney Disease Stage 3B-5

The Dietary intervention is one of the major components of therapy for patients with chronic kidney disease (CKD), aiming to minimize uremic symptoms and to provide optimal nutritional status. For slowing the progression of renal failure, dietary protein restriction has been recommended for patients with CKD. However, receiving lower doses of this dietary intervention reduces its effectiveness and results in usage attrition and patient dropout. Therefore, dietary compliance has become a well-recognized challenge to the development of effective dietary protein restriction interventions. Using a food journaling app to log dietary intake has been shown to benefit people and health researchers. We hypothesized that using a food journaling app affects patients' dietary compliance (the first hypothesis), and indirectly improves health outcomes because of the increased compliance (the second hypothesis). We conducted a 12-week dietary protein restriction intervention. Twenty recruited participants were required to eat low-protein meals (0.6 g/kg ideal body weight/day), and self-report their dietary intake by using a food journaling app. Thirteen of 20 participants completed the dietary protein restriction intervention, and their health outcomes were measured according to changes in blood urea nitrogen, serum creatinine, albumin, and glycated hemoglobin compared with those who dropped out. The empirical results support the first hypothesis and show that using the food journaling app can significantly increase the dietary compliance, but the results regarding the second hypothesis were not significant.