Updated: Mar 23
March is National Kidney Month, and we worked with a Registered Dietitian to help us learn about her role in working with patients who are coping with Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) and what we can to support out CKD and ESRD population.
End Stage Renal Disease, also known as End Stage Kidney Disease, is defined as occurring when chronic kidney disease – the gradual loss of kidney function – reaches an advanced state. They state that in End Stage Kidney Disease, your kidneys are not functioning enough to meet your body’s needs. Your kidneys are highly adaptable and able to compensate for lost function- so signs and symptoms of CKD/ESRD may not appear until irreversible damage has occurred.
There are multiple risk factors for CKD including but not limited to:
High blood pressure
Lower-level kidney functions/infections
There are many preventative steps that you can take to avoid CKD. They recommend losing weight if necessary, maintaining an active lifestyle and balanced diet. Controlling your blood pressure and blood sugar levels are also important steps in CKD prevention.
We spoke with Registered Dietitian Natalie Antypas regarding how she supports patients who are living with CKD and her recommendations on how to live a healthier lifestyle to prevent CKD development.
1. What role does a nutritionist/dietitian play on an inter-professional team for a CKD/ESRD patient?
Dietitians are the primary practitioners who educate and counsel renal patients on the role that food and dietary choices play on that body and in particular the kidneys.
2. What kind of dietary modifications are common for a CKD/ESRD patient?
Dietary modifications for renal patients greatly depend on the stage of disease and whether or not they are on dialysis. For CKD patients in stages I-IV, not yet on dialysis, there tends to be more dietary restrictions. One of the kidneys’ primary functions is to filter out excess electrolytes and protein that our body does not utilize. Because the kidneys are unable to function properly when in renal failure, it is Important to limit the foods that are higher in potassium, sodium, and phosphorus as well as a moderate consumption of protein. Some examples of these foods include potatoes and tomatoes (high potassium), processed foods and deli meats (high sodium), and dairy products and dark sodas (high phosphorus). A moderate amount of protein would include a single serving (4-6oz) of either meat, poultry, fish, or eggs with every meal.
For patients who are on dialysis, these restrictions are similar; however, electrolytes are more closely monitored and corrected during dialysis, and therefore restrictions can sometimes be loosened. Additionally, higher protein is emphasized due to increased loss of protein during dialysis. Protein supplements are often recommended to assist with increased protein needs. As with all nutrition counseling, medical nutrition therapy for renal patients is greatly individualized and tailored towards an individual’s specific needs.
3. What challenges and difficulties do CKD/ESRD patients face daily, and how do you help them?
As noted above, dietary restrictions for CKD/ESRD patients can be overwhelming and difficult to follow. For this reason, patients often face challenges with adherence on a daily basis. In order to help maintain compliance, it is crucial for renal patients to meet regularly with a registered dietitian. Another challenge that these patients face is the frequency of dialysis sessions. A patient on dialysis may undergo dialysis anywhere between 3-4 days per week. Dietitians are typically available at most outpatient dialysis clinics for nutrition counseling and can help to keep patients accountable with their diet and dietary choices.
4. How do nutritionists support patients who have CKD/ESRD?
Dietitians provide a unique set of skills and utilize evidenced based knowledge to contribute nutritional expertise and collaborate with the interdisciplinary team to support and care for renal patients. Medical nutrition therapy is a preventative measure that can eliminate further complication and progression of the disease. Therefore, with a dietitian’s support, accountability, and compassion, renal patients can have better outcomes and lead a better life.
Dietary modifications are a vital role for keeping CKD patients at their healthiest no matter what stage of disease and we are greatly appreciative of Natalie taking the time to speak on the topic and help to educate our community. Valeda RX is proud to support our CKD patients through personalized clinical management programs and diminishing the financial burden of CKD through additional patient support programs. We are grateful to have the opportunity to care for our patients as one part of our interprofessional team.
About Valeda Rx
Valeda Rx is an independent national specialty pharmacy, servicing 49 US States and the District of Colombia, with California pending. We are focused on improving the care for patients living with complex and chronic conditions such as Hepatitis C, HIV, Multiple Sclerosis, Rheumatoid Arthritis, Psoriasis, Crohn's, Oncology Diseases and more. Our Care Team puts patients’ needs first, treating each as though they were part of our own family.
By working together to coordinate the right medication for the right therapy at the right time for our patients, we support and guide the improvement of patient outcomes. Whether you are a patient, caregiver, prescriber or partner, you will receive the type of independent care and attention and service you not only need, but that you also deserve.