Reviewed by Sharon Denny, MS, RDN
The kidneys perform many important functions, including the removal of waste products and excess fluids, and the critical regulation of the body's protein, sodium and potassium levels. If the kidneys aren't working well, they don't filter blood properly, which means harmful substances can accumulate in the blood. Normal kidney function is necessary to maintain a stable balance of body chemicals. If you have kidney disease, a registered dietitian nutritionist (RDN) can teach you how to choose foods that will ease the workload on your kidneys.
Types and Causes of Kidney Disease
Kidney disease is categorized as acute or chronic, and there are more than 40 different types. Acute kidney disease results following a complication of serious infection, injury or trauma to the kidney or multiple organ failure, which may lead to permanent loss of kidney function. But if the kidneys have not been badly damaged, they can return to normal health. However, chronic kidney disease is usually an irreversible and progressive disease that can lead to kidney failure over time if not treated. This category of disease is most commonly caused by poorly controlled diabetes and high blood pressure. An RDN can provide medical nutrition therapy to help manage all categories of kidney disease and maintain optimal nutrient intake.
What Is Medical Nutrition Therapy?
Medical nutrition therapy includes a lifestyle examination, a thorough review of current diet and eating habits and development of a personalized nutrition treatment plan. These services are covered by a variety of insurance plans. Medicare Part B covers medical nutrition therapy for diabetes and kidney disease; patients with private insurance should check their individual plan for specific coverage details. Many RDNs have received extensive training in this field and can provide these services — including nutritional assessment, education and individual counseling — to address specific dietary needs and preferences.
Why a Dietitian?
RDNs are food and nutrition experts who have completed multiple levels of training established by the Academy of Nutrition and Dietetics. People with kidney disease will likely need to follow a diet with specific daily amounts of protein, sodium, and potassium. Keeping those nutrient levels in check can help prevent progression of the disease. An RDN will teach patients how to eat well and manage this vital part of their health plan. "Just as you would see a heart specialist for a heart condition or an endocrinologist for managing your diabetes, it is important to see an RDN specializing in kidney disease to better address your kidney disease–specific nutritional goals," says Vandana Sheth, RDN, CDE, and spokesperson for the Academy of Nutrition and Dietetics.
How Does the Dietitian Help?
People with kidney disease need to make adjustments to diet and lifestyle to help live a longer and healthier life. Because heart attack and stroke are more common among people with kidney disease, these changes are good for the heart and kidneys. Dietitians can provide more detailed information about how to eat and practical tips to address daily challenges. A dietitian can help develop an eating and exercise plan that considers individual food preferences, level of physical activity, lifestyle and special needs to help accomplish disease management goals. "An RDN can help people with kidney disease better understand basic dietary guidelines for renal insufficiency, and address nutritional concerns while preserving and maintaining kidney function," says Sheth.
What Should I Expect?
The length of a visit with an RDN may vary; the first visit will typically be an in-depth assessment, including a patient's food and nutrition habits, and review of laboratory information, medical history, and psychosocial history. Data collected during this visit will provide the RDN with insight to help form a more comprehensive and customized nutrition care plan. Along with identifying nutritional areas of concern, the dietitian will provide patients with education and assist in the creation of short-term goals to address these issues.
The RDN will determine an appropriate follow-up schedule to monitor progress. Each follow-up session will begin with a review of previous goals and an evaluation of what worked and what didn't work. Changes that may have occurred since the last visit will be addressed, and nutrition plans will be adjusted as necessary. "The ultimate goal of an RDN's treatment for patients with kidney disease is to enhance their quality of life while protecting their kidney function," says Sheth.
Learn more about kidney disease and nutrition »
Reviewed July 2013