Food for thought: How renal dietitians help their patients live healthy lives

When it comes to nutrition for those living with kidney disease, there is no one-size-fits-all approach. If anyone knows this well, it is Paige and Nikki who are renal dietitians in the Renal Program at Brampton Civic (Nikki is far left and Paige is far right in the photo above with fellow colleagues). Their ultimate goal is to provide nutritional guidance for patients at various stages of kidney disease and help them live healthy lives. We spoke with Nikki and Paige about their unique role.

First thing’s first, what is your job as a renal dietitian?

Our job as renal dietitians is to support patients with their nutrition while living with chronic kidney disease.

We work with our patients to promote healthy eating to delay the progression of kidney disease, maintain bloodwork within normal limits, and prevent chronic disease malnutrition.

We help translate the science into practical food advice on what patients can eat, drink, and how to put together nutritious meals that work for their individual dietary needs.

Who do you treat?

We work with patients at various stages of chronic kidney disease. Many of our patients have diabetes and hypertension as these are leading causes of chronic kidney disease.

We see patients within the multi-care kidney clinic who are not on dialysis as well as patients undergoing in-centre hemodialysis treatments and home dialysis. We are part of a larger care team that provides a full assessment and treatment plan including nephrologists, social workers, pharmacists and nurses.

In general, what nutrition guidance do you share with your patients?

It is important to keep in mind that every patient has individualized needs. This is based on their stage of kidney disease, bloodwork, medications, nutritional status, social history and more. We assess each patient comprehensively and develop a personalized diet education and meal plan based on our assessment.

In general, we encourage our patients to eat less processed foods, reduce salt and focus on eating more whole foods and plant-based meals. However, each patient is different and sometimes general advice does not work for everyone.

What do you find is the most helpful approach for helping patients welcome nutrition changes?

We do our best to keep things positive - we emphasize what patients can eat versus what they can’t. We offer creative ways to incorporate healthier, kidney-friendly items into the food and meals they already eat.

We find this can help patients adopt new diet changes as we consider their preferences to maintain a positive experience with meal time and eating with new these changes in place.

What is the biggest misconception around nutrition and kidney health?

Nutrition for patients living with chronic kidney disease is not a one-size-fits-all approach. As we’ve mentioned, it is very individualized and what is beneficial for one patient may not be for another.

There is a lot of general information - and misinformation - on the internet that may be ineffective or even harmful to patients. As such, we always recommend our patients to follow their personalized advice and speak with their renal dietitian if they have any questions.

What is the most rewarding part of your job?

Living with chronic kidney disease can be overwhelming. We love having the opportunity to work through new changes with patients, one-on-one, to improve their quality of life.

It’s also incredibly rewarding to see those tangible improvements. A lot of our nutrition interventions are based on working towards getting their blood work within normal limits. When our patients achieve that goal, following up with them is so rewarding. These are some of our favourite days!