Specialized nutrition experts are key to better outcomes and improved patient lives, from chronic kidney disease to end-stage renal disease.

In the landscape of kidney disease management, from chronic kidney disease (CKD) to end stage kidney disease (ESKD), dietitians stand as essential figures. While their work often occurs behind the scenes, their impact on clinical outcomes, patient adherence, and reducing costly complications is profound. These specialized professionals play a pivotal role that goes far beyond simply providing meal plans, especially for those facing the challenges of ESKD.

The Clinical Cornerstone: Personalized Nutrition for Complex Needs

Dietitians are highly trained clinicians who craft individualized nutrition plans — what some might call "nutrition prescriptions" — for each patient, whether they are managing early-stage CKD or navigating the complexities of ESKD. They carefully analyze lab data, medication schedules, existing health conditions, and lifestyle factors to create dynamic plans. These plans address the unique mineral and fluid imbalances at each stage of kidney disease and are adjusted based on ongoing lab results and patient feedback.

Slowing Kidney Disease Progression

Nutrition management has been shown to help slow the advancement of CKD, potentially delaying the need for dialysis. For those who progress to ESKD, a kidney-friendly diet remains crucial in managing the complications of dialysis and improving quality of life. Since CKD is progressive, the nutrition recommendations can exist on a sliding scale and a dietitian can help make tailored recommendations depending on the stage and other health conditions.

Improving Key Lab Values

Dietitians help play a vital role in managing lab values, such as phosphorus and potassium levels, which, if uncontrolled, can lead to heart problems and increased risk of death, particularly in ESKD patients. By creating personalized dietary plans, dietitians help stabilize these crucial lab values. They also focus on incorporating adequate protein intake to maintain healthy albumin levels, a key predictor of survival for dialysis patients.

Reducing the Impact of Comorbidities

Dietary intervention is also crucial for managing conditions like diabetes and hypertension, major contributors to CKD and significant challenges in ESKD. By helping patients better manage their blood sugar and blood pressure, dietitians support reduction in the overall burden on both the patient and the healthcare system. This is particularly important in preventing complications and hospitalizations in ESKD patients and delaying CKD progression in earlier stages.

These positive impacts of a dietitian’s guidance is felt across the healthcare journey. By empowering patients to maintain stability and better manage their health needs — especially when managing ESKD — dietitians can help reduce the frequency of serious and costly complications that affect quality of life. Fluid overload, for example, is a common and serious challenge for people who need dialysis as well as a leading cause of hospitalization that can be reduced through dedicated dietary support.

Comprehensive Support: DaVita’s Care Model in Action

“Proactive nutritional management is one of the cornerstones of holistic care,” says Amanda Wetherington, a dietitian for DaVita Integrated Kidney Care (IKC). “By working with the rest of the care team, we work to empower individuals in avoiding physical and emotional setbacks in their kidney health journey.”

This focus on prevention and maintenance reinforces a care model centered on long-term patient well-being and a higher quality of life. A core care team for every patient offers an interdisciplinary approach – including nephrologists, nurses, social workers and patient care technicians — to provide comprehensive care centered on individualized needs throughout the kidney care journey.

Through personalized, high-touch support, DaVita dietitians offer one-on-one counseling for patients and participate in monthly reviews of lab trends with the entire care team. They’re also able to leverage DaVita® resources, including DaVita Diet Helper and a comprehensive library of recipes and cookbooks, to help patients stay on track and find foods that support not only their health needs but their lifestyles and preferences, too.

By prioritizing the role of dietitians within an integrated care team, healthcare organizations can optimize results and deliver early intervention to help manage CKD — as well as common comorbid conditions including diabetes and high blood pressure — through early education and behavior changes.

“Food plays such an important role in our lives, and understanding nutrition needs can make a significant difference,” Wetherington shares. “The most common sentiment I hear from the people I work with living with CKD is that having access to a dietitian was the missing piece in their CKD healthcare.”