Nutrition News

Following are reviews of select abstracts from the 2014 meeting of the Council of Renal Nutrition that took place April 23-26 as part of the National Kidney Foundation’s Spring Clinical Meeting in Las Vegas. The abstracts were selected by NN&I editorial advisory board members Jane H. Greene, RD, LDN, and Peggy Harum, RD, LD.

Editor’s note: This article is based on excerpts from the upcoming second edition of, “Healthy Eating for Chronic Kidney Disease Patients,” written by NN&I editorial advisory board member Peggy Harum, RD, LD.The book will soon be available on Amazon and through Barnes and Noble as an eBook. Peggy can be reached at peggyharum@yahoo.com for more information.

Staging the severity of chronic kidney disease CKD (Stages 1-5) began in 2001 when nephrologist Andrew Levey introduced the concept at the annual Spring Clinicals meeting of the National Kidney Foundation. A decade later in 2012, staging now includes checking for albuminuria or protein in the urine, because this can be treated with medications.

Congratulations! You have been hired as a renal dietitian. Now the next step is reviewing all you have learned about renal nutrition in the past and seeking out new information to get ready to help your patients.

Impax Laboratories Inc. has begun shipping authorized generic Renvela (sevelamer carbonate 800 mg tablets), the company announced April 16. Renvela is indicated for the control of serum phosphorus in patients with chronic kidney disease on dialysis.

The U.S. Food and Drug Administration has approved Velphoro (sucroferric oxyhydroxide) to control serum phosphorus levels in patients with chronic kidney disease on dialysis. Velphoro, developed by the Swiss company Vifor Pharma and transferred to Vifor Fresenius Medical Care Renal Pharma, will be marketed by Fresenius Medical Care North America in 2014.

Losing belly fat and cutting back consumption of phosphorus found in processed foods and dietary protein may reduce risk for developing kidney disease, according to a new study published in the November issue of the American Journal of Kidney Diseases. Researchers found that diminishing waist circumference and consuming less dietary phosphorus were linked with reduced levels of albuminuria, or protein in the urine.

A new report from BioTrends Research group found that the use of phosphate binders in the United States has declined in the hemodialysis and peritoneal dialysis setting over the past two years.   The ChartTrends: Bone and Mineral Metabolism in Dialysis (U.S.) 2013 report is a syndicated report series, in which 251 U.S. nephrologists provided patient chart data on 1,014 dialysis patients in the United States to uncover the management related to bone and mineral metabolism.  The report also found that physicians are initiating phosphate binders at higher serum phosphorous levels compared to last year. In addition, a significantly higher percentage of patient charts indicate that cost and the belief that phosphorous is low in the priority of treatment as two reasons for non-binder use compared to 2012.   The report also finds that Sanofi’s sevelamer (Renagel, Renvela) is the market share leader in the dialysis patient population, with little change in share amongst the other binder brands compared to last year, with the exception of a decline in the use of calcium acetate.   Patients on non-calcium based binders (particularly Shire’s Fosrenol) are more likely to be on Amgen’s Sensipar compared to those on calcium-based binders, particularly calcium acetate.  From 2012 to 2013, use of Sensipar appears to be declining in the hemodialysis patient population.   “Despite the delay in the inclusion of orals in the dialysis bundle, we are starting to see changes in the dialysis setting likely driven by increased scrutiny and awareness of the total costs of treatment,” said BioTrends Director Rob Dubman. “For example, we are now finding a rise in the use of nutritional Vitamin D and less use of AbbVie’s Zemplar compared with 2012.”  

Recognizing the important role that diet and registered dietitians play in chronic kidney disease management, the National Kidney Disease Education Program (www.nkdep.nih.gov) convened a panel of renal dietitians with expertise in CKD at the American Dietetic Association Food and Nutrition Conference held last fall in Denver. Our panel represented a wide array of experience from different settings: dialysis clinics, private practice, and teaching universities (see box for panel members).

The American Dietetic Association has published new evidence-based practice guidelines on nutrition treatment for registered dietitians who treat people with chronic kidney disease. 

The focus of ADA’s practice guideline is on medical nutrition therapy for adults with chronic kidney disease stages 1 - 5, including post-kidney transplant but who are not on dialysis.