DIET IN THE MANAGEMENT OF NON-DIALYSIS DEPENDENT CHRONIC KIDNEY DISEASE (CKD): PERCEPTIONS AND EXPERIENCES OF PATIENTS LIVING WITH RENAL DISEASE
Stephanie Notaras1,2, Angela Makris 1,2, Kelly Lambert 3, Janette Perz2 1South Western Sydney Local Health District, Liverpool, New South Wales, Australia2Western Sydney University, Campbelltown, New South Wales, Australia3University of Wollongong, Wollongong, New South Wales, Australia
Abstract
Aim: Explore the views and experiences of patients living with non-dialysis dependent CKD on the role of diet in disease management.
Background: Nutrition recommendations that have been shown to reduce CKD progression can be confusing and adherence difficult. Access to renal dietitians prior to dialysis is often limited. Little is known about the patient experience with dietary changes and their perceptions of the role of nutrition in non-dialysis dependent CKD.
Methods: A 32-item online survey was distributed via patient-advocacy kidney organisations, CKD Facebook groups and renal clinics at Liverpool Hospital. Data was analysed descriptively. Categorical variables were assessed to determine associations. Analysis with SPSS v28.
Results: Overall, 994 renal patients completed the survey (75% female, 65% aged 50 and over, 50% in stages 3-5 CKD). Diet for CKD management was rated as very-extremely important (78%). Over 70% of patients reported not being referred to a dietitian by their nephrologist. Referrals were significantly less likely for those with stages 1-3 CKD (p<0.001). Most common diets perceived to help reduce CKD progression were low salt (80%), low protein (57%) and vegetarian/vegan diets (48%). Challenges patients cited with changing dietary behaviours were difficulty in following and amalgamating together conflicting information, eating out and reduced food enjoyment. Patient identified support in overcoming challenges included access and frequency of appointments with renal dietitians and better nutrition resources.
Conclusions: Although diet is perceived as an important part of CKD management at all stages, patients are not routinely referred to renal dietitians, more so earlier in their CKD journey. Implementation of nutrition recommendations is currently lacking. Changing current models of care to include earlier referral access to renal dietetic services is recommended.
Biography
Stephanie Notaras is Renal Dietitian with a Masters in Counselling and a PhD Candidate. She is investigating the impact of dietetic intervention on chronic kidney disease progression and behaviour change elements that may improve patient outcomes. Stephanie trains dietitians on a counselling and behaviour change framework she has developed, evaluated and published. She also lectures on this topic at a university level. Her career mission is to help people living with chronic kidney disease receive earlier access to renal dietetic services to assist them in slowing down progression with eating behaviour change interventions.