This article is more than 5 years old. Information may no longer be current.
Medical nutrition therapy may slow progression of CKD, reduce health care costs
Although medical nutrition therapy may slow the progression of CKD and reduce health care costs, data suggest 90% of non-dialysis users never meet with a dietitian, according to a report published in the Journal of the Academy of Nutrition and Dietetics.
In their study, Holly Kramer, MD, MPH, of Loyola Medicine and Loyola University Chicago Stritch School of Medicine, and colleagues looked at the reasons for low use of medical nutrition therapy services and possible methods to increase use. According to the researchers, increasing use of medical nutrition therapy should improve risk factor control of diabetes and hypertension, slow the progression of CKD and reduce costs of care.
“Unfortunately, few patients with CKD are receiving any [medical nutrition therapy] MNT services until they initiate dialysis,” the researchers wrote.
According to a press release from Loyola University Health System, Medicare spends $33 billion a year on patients on dialysis and costs for kidney patients not on dialysis are higher than the costs of treating stroke or cancer. The incidence of chronic kidney disease is expected to increase in the next 20 years due to the obesity epidemic and aging population.
“Most adults with chronic kidney disease remain poorly informed of how diet influences disease management and progression,” Kramer and colleagues wrote.
Medical nutrition therapy consists of individualized nutrition assessment, care planning and dietary education by a registered dietitian nutritionist. Although patients may receive dietary counseling from physicians or nurses, the release noted that such counseling often is brief and typically involves broad suggestions such as reducing salt or protein intake. By contrast, medical nutrition therapy includes an in-depth individualized nutrition assessment, personalized treatment plan and periodic monitoring and reassessment.
According to the study, medical nutrition therapy is recommended by the National Kidney Foundation and the Academy of Nutrition and Dietetics for all persons with CKD regardless of stage and is recommended by the American Diabetes Association for all patients with diabetes.
According to the release from Loyola University Health System, there are several reasons why few kidney patients receive medical nutrition therapy. Some physicians do not refer patients to medical nutrition therapy under the belief the therapy is not covered. Other doctors may not recognize the role dietary factors play in kidney disease or lack confidence that medical nutrition therapy will be effective. Some patients may be reluctant to invest the time and money in medical nutrition therapy. Moreover, a limited number of registered dietitian nutritionists are trained in kidney disease management and many are not enrolled as Medicare providers.
Editor’s Note: On Aug. 6, we corrected the headline and lede of this article to more accurately reflect the findings. The editors regret this error.