Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

Article, Review English OPEN
Beto, Judith A ; Schury, Katherine A ; Bansal, Vinod K (2016)
  • Publisher: Dove Medical Press
  • Journal: International Journal of Nephrology and Renovascular Disease, volume 9, pages 21-33 (issn: 1178-7058, eissn: 1178-7058)
  • Related identifiers: doi: 10.2147/IJNRD.S76831, pmc: PMC4749088
  • Subject: nutrition education | Diseases of the genitourinary system. Urology | Nutrition | chronic kidney disease | RC870-923 | education strategies | adherence | Review | hemodialysis | technology-enhanced learning | International Journal of Nephrology and Renovascular Disease | talking control

Judith A Beto, Katherine A Schury, Vinod K Bansal Division of Nephrology and Hypertension, Loyola University Healthcare System, Loyola University of Chicago, Maywood, IL, USA Abstract: Chronic kidney disease (CKD) requires extensive changes to food and lifestyle. Poor adherence to diet, medications, and treatments has been estimated to vary between 20% and 70%, which in turn can contribute to increased mortality and morbidity. Delivering effective nutritional advice in patients with CKD coordinates multiple diet components including calories, protein, sodium, potassium, calcium, phosphorus, and fluid. Dietary intake studies have shown difficulty in adhering to the scope and complexity of the CKD diet parameters. No single educational or clinical strategy has been shown to be consistently effective across CKD populations. Highest adherence has been observed when both diet and education efforts are individualized to each patient and adapted over time to changing lifestyle and CKD variables. This narrative review and commentary summarizes nutrition education literature and published strategies for providing nutritional advice in CKD. A cohort of practical and effective strategies for increasing dietary adherence to nutritional advice are provided that include communicating with "talking control" principles, integrating patient-owned technology, acknowledging the typical food pattern may be snacking rather than formal meals, focusing on a single goal rather than multiple goals, creating active learning and coping strategies (frozen sandwiches, visual hands-on activities, planting herb gardens), and involving the total patient food environment. Keywords: talking control, technology-enhanced learning, hemodialysis, nutrition education, education strategies
  • References (65)
    65 references, page 1 of 7

    1. Webb D, Byrd-Bredbenner C. Overcoming consumer inertia to dietary guidance. Adv Nutr. 2015;6(4):391-396.

    2. Jensen MD, Ryan DH, Apovian CM, et al. AHA/ADD/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2013;129(25 Suppl 2):S102-S138.

    3. Kahneman D. Thinking, Fast and Slow. London, UK: Penguin Books, 2011.

    4. Karamanidou C, Clatworthy J, Weinman J, Horne R. A systematic review of the prevalence and determinants of nonadherence to phosphate binding medication in patients with end-stage renal disease. BMC Nephrol. 2008;9:2.

    5. Hsu KL, Fink JC, Ginsberg JS, et al. Self-reported medication adherence and adverse patient safety events in CKD. Am J Kidney Dis. 2015;66(4):621-629.

    6. Ibrahim S, Hossam M, Belal D. Study of non-compliance among chronic hemodialysis patients and its impact on patients' outcomes. Saudi J Kidney Dis Transpl. 2015;26(2):243-249.

    7. Beto JA, Ramirez WE, Bansal VK. Medical nutrition therapy in adults with chronic kidney disease: integrating evidence and consensus into practice for the generalist registered dietitian nutritionist. J Acad Nutr Diet. 2014;114(7):1077-1087.

    8. National Kidney Foundation. KDOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis. 2001;37(1 Suppl 2): S66-S70.

    9. National Kidney Foundation. KDOQI clinical practice guideline for nutrition in children with CKD: 2008 update. Am J Kidney Dis. 2009;53(Suppl 2): S1-S124.

    10. National Kidney Foundation Council on Renal Nutrition. Pocket Guide to Nutrition Assessment of the Patient with Kidney Disease. 5th ed. McCann L, editor. New York: National Kidney Foundation, 2015.

  • Metrics
    No metrics available
Share - Bookmark