Collaboration as a Tool in Managing Nutrition for Patients With CKD

In this Roundtable Wrap-Up, we offer an abbreviated version of the roundtable discussion on the role of nutrition in a patient with chronic kidney disease (CKD).

For more expert insights, watch the full Multidisciplinary Roundtable.

The content below has been edited for space and clarity.

 Wayne Kotzker, MD, on how he helps patients manage their potassium levels

You have to manage patients and what their preferences are. We have one of these guides that has low, medium, and high potassium foods so that they can see that if I'm saying you need to limit potassium, well there are alternatives on the lower side that you can substitute for the higher. Again, I would certainly refer to a dietician to help manage.

 Lance Berger, MD, on discussing statin therapy with patients

When I explain to patients the benefits of statin therapy and I sit with them and I draw them what the plaque looks like, and I discuss the concept of a vulnerable versus invulnerable plaque and I take the time to go through it, you see the light bulb go off and they're much more likely to take the treatment, and especially the CKD patients who as we've mentioned are very high risk for cardiovascular events. 

 Maria Ciminelli, MD, on the importance of patients with CKD having a support system for care

For me, it just gets back down to the education, but then also incorporating and engaging support systems for the patient, whether it be their family member who does the cooking, somebody else who can help them in terms of exercise, but it's very important to get others involved in their care.

 Jamie Miller, RD, on ways to educate patients about nutritional care for the disease

We can educate patients while they're in the clinic or even over the phone or answer any questions that they may have, but when it comes to having something printed out for them or something available for them to reference when they're home and their significant other or their family member or caregiver is trying to figure out what they can and can't eat, or maybe thinking of new recipes to try.

There are certainly a lot of different really great resources, especially online. Of course, we always want to make sure that they're evidence-based because the internet can be a little scary when it comes to patients looking for information on how to manage kidney disease and diabetes and all of that.

 Lance Berger, MD, on the collaboration between health care providers

The other part of the collaboration I think is really essential is to have our other providers, nephrologists, and primary care doctors in the loop as well. If somebody's seeing a nephrologist, I want to make sure that my progress notes are going there…The collaboration that we've mentioned on a couple of occasions today is really essential for better outcomes. Having a dietician involved and having us all speaking together reduces cross purposes that we're sometimes acting towards each other. I think that's critical.

 Maria Ciminelli, MD, on the primary care perspective of managing a patient with CKD

And just to be empathic with our patients and to really listen to them. That's a component that I think is important from the primary care perspective is to be empathetic, to listen, to try to help them in terms of reinforcing the tools that people like Jamie and the dieticians will give our patients all.