Chronic kidney disease patients living in health care communities, such as nursing facilities and assisted living facilities, face unique challenges related to maintaining a renal-specific diet. A recent article in the Journal of Renal Nutrition, suggests the controlled meal environment may have a more negative effect on residents nutritional status than a positive one. “When initially considered, the average person may be quick to conclude that diets are better managed in health care communities than at home,” writes Julie Hulsebus-Colvin, MBA, RD,CDN. However, this control and inflexibility regarding meal times and portion sizes can have a negative effect on a patient’s nutritional status, particularly on a patient with CKD.
Other challenges presented by a controlled health care setting include: missed meals that may not be compensated for during dialysis sessions, a rigid CKD diet made to cover all patients, low or poor protein content of meals, limited nutritional supplements, suboptimal meal substitutions, poor nutrition labeling, and high potassium levels. CKD diets aren’t “one size fits all” and need to be tailored to each patients’ individual needs.
The author suggests a partnership between the renal dietitians and the staff in the health care community to improve the diets of renal patients. Offering CKD nutrition education may be helpful in achieving patients’ nutritional goals in this setting and effective communication between parties is critical. Colvin argues that placing the CKD patient first will lead to better outcomes and improved integration and continuity of nutrition care.
