{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:44Z","timestamp":1792471124313,"version":"4.5.0"},"reference-count":56,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lifestyle interventions targeting metabolic health may influence chronic kidney disease (CKD) risk, particularly among adults with type 2 diabetes and obesity. We evaluated real\u2010world associations between a telehealth\u2010delivered, individualized nutrition therapy program (VINT) and CKD incidence and progression compared with usual care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective, propensity score\u2013matched cohort study using the Komodo Healthcare Map, a longitudinal U.S. administrative claims database. Adults enrolled in a telehealth\u2010delivered nutrition therapy emphasising carbohydrate reduction, VINT (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911\u2009077) were matched 1:1 to usual\u2010care controls on demographic, clinical, and medication covariates, over 5\u2009years of follow\u2010up. Primary outcomes were new\u2010onset CKD, CKD stage \u2265\u20093, and CKD stage \u2265\u20094. Secondary outcomes included renal safety events. Cox proportional hazards and Poisson regression models were used to estimate hazard ratios (HRs) and incidence rate ratios (IRRs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      VINT participation was associated with a lower incidence of new\u2010onset CKD (10.1 vs. 15.6 per 1000 person\u2010years; HR 0.64, 95% CI 0.53\u20130.77;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), CKD stage \u2265\u20093 (HR 0.57, 95% CI 0.45\u20130.73;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and CKD stage \u2265\u20094 (HR 0.38, 95% CI 0.18\u20130.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). No increased risk of kidney stones, metabolic acidosis, diabetic ketoacidosis, or gout was observed in VINT compared with the UC group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large, real\u2010world matched cohort, participation in a telehealth\u2010delivered nutrition therapy emphasising carbohydrate reduction was associated with lower CKD incidence and progression without increased renal adverse events. These findings suggest that individualized nutrition therapy may be a safe and scalable approach to CKD prevention and management in adults with metabolic disease, warranting further prospective investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71086","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:15:00Z","timestamp":1784261700000},"page":"9054-9068","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of Telehealth Low\u2010Carbohydrate Intervention in Preventing Chronic Kidney Disease: A Real\u2010World, Retrospective, Matched Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5427-6748","authenticated-orcid":false,"given":"Shaminie J.","family":"Athinarayanan","sequence":"first","affiliation":[{"name":"Research Department Virta Health  Denver Colorado 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff S.","family":"Volek","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, College of Education and Human Ecology The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Himmelfarb","sequence":"additional","affiliation":[{"name":"Department of Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Renal Diseases and Hypertension, Department of Medicine University of Colorado Anschutz Medical Campus  Aurora Colorado 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