Community Health Worker Support for Latino Individuals on Dialysis: The Navigate-Kidney Randomized Clinical Trial

Background: Latino individuals with dialysis-dependent kidney failure face social barriers (e.g., food insecurity, low health literacy) that may increase interdialytic weight gain (IDWG), a contributor to hospitalizations. Minimizing IDWG is a patient priority but remains common despite dietary education. We tested if community health worker (CHW) support reduces IDWG. Methods: Design & Participants: This parallel group, unblinded RCT at 5 Colorado dialysis centers (Nov 2020-Aug 2022) included self-identified Latino adults on dialysis. Intervention: Participants were randomized 1:1 to the Navigate-Kidney intervention or standard care (SC). CHWs followed a framework-driven protocol addressing social needs, health navigation, and kidney care education for 4 months, meeting participants biweekly. Outcomes: The primary outcome was change in IDWG (% of estimated dry weight) from 90 days pre- to 180 days post-intervention. Secondary outcomes were missed/shortened sessions and patient activation. Between-group IDWG differences were estimated using piecewise linear mixed models. Results: 139 participants (mean age 57 [SD13]; 51% males) were randomized, 68 to Navigate-Kidney. Most were poor with low health literacy. Post-intervention IDWG trends differed between groups (p=0.01), with a -0.46% (95% CI: -0.78%, -0.14%) difference at 180 days. Navigate-Kidney also reduced shortened sessions (p=0.02) and improved patient activation (p=0.005). Conclusion: CHW support is a practical way to improve outcomes in Latino patients on dialysis. Funding: NIDDK Support