Efficacy and implementation of digital health interventions in chronic kidney disease: an umbrella review of systematic evidence.

This umbrella review aimed to synthesize and critically appraise high-level evidence on the effectiveness of digital health interventions across the chronic kidney disease (CKD) continuum, encompassing predialysis, dialysis, and kidney transplant populations, with a focus on patient-centered, behavioral, clinical, and psychosocial outcomes. A systematic search of English peer-reviewed literature up to December 18, 2025, identified 16 eligible systematic reviews and meta-analyses. Methodological quality and risk of bias were assessed using AMSTAR-2 and ROBIS, respectively, and data were independently extracted by independent reviewers in accordance with PRIOR guidelines. Across the included reviews, digital health interventions-such as mobile health applications, telehealth platforms, telemonitoring systems, wearable devices, and web-based self-management tools-demonstrated consistent benefits for proximal outcomes. These included improvements in medication and dialysis adherence, dietary and fluid management, self-efficacy, psychological well-being, and health-related quality of life. Notably, multicomponent interventions with reminders, interactive education, gamification, and personalized feedback were especially effective in promoting engagement and sustained behavior change. Nonetheless, effects on distal clinical outcomes-such as kidney function (estimated glomerular filtration rate), biochemical parameters, hospitalization rates, and long-term morbidity-were heterogeneous and often inconclusive, reflecting variability in study designs, populations, and follow-up durations. Overall, the quality of evidence ranged from low to moderate, with substantial heterogeneity across intervention types, outcome measures, and reporting standards, highlighting the need for standardized frameworks and core outcome sets in future research. Digital health interventions appear effective in enhancing CKD self-management and improving patient-centered outcomes. However, more rigorous and standardized research is required to establish their long-term clinical impact.