Disclosures: Wang reports serving as a scientific advisor of member of Editorial Boards for American Journal of Nephrology, Biomedicine Hub, Blood Purification, Clinical Journal of the American Society of Nephrology, EMJ Nephrology, Journal of the American Society of Nephrology, Journal of Diabetes, Journal of Geriatric Cardiology, Journal of Nephrology, Journal of Renal Nutrition, Kidney International, Nephrology Dialysis Transplantation, Nephron Clinical Practice (Associate Editor); serving as President of International Society of Renal Nutrition and Metabolism, council member of International Society for Peritoneal Dialysis, executive committee member of Standardizing Outcomes in Nephrology Initiatives, committee member of ISN-Advancing Clinical Trials, deputy chair of ISN North and East Asia Regional Board, and deputy chair of ISN Education working group; and other interests/relationships as president of International Society of Renal Nutrition and Metabolism, committee member of ISN-Advancing Clinical Trials, member of Standardizing Outcomes in Nephrology Initiatives-HD Cardiovascular Disease Outcome Measures Working Group, member of SONG-PD Working Group, executive committee member of Standardizing Outcomes in Nephrology Initiatives, council member of International Society for Peritoneal Dialysis, deputy chair of ISN Regional Board, and deputy chair of ISN Education working group.

January 04, 2022
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Nutrition-related care globally limited for patients with kidney disease

Disclosures: Wang reports serving as a scientific advisor of member of Editorial Boards for American Journal of Nephrology, Biomedicine Hub, Blood Purification, Clinical Journal of the American Society of Nephrology, EMJ Nephrology, Journal of the American Society of Nephrology, Journal of Diabetes, Journal of Geriatric Cardiology, Journal of Nephrology, Journal of Renal Nutrition, Kidney International, Nephrology Dialysis Transplantation, Nephron Clinical Practice (Associate Editor); serving as President of International Society of Renal Nutrition and Metabolism, council member of International Society for Peritoneal Dialysis, executive committee member of Standardizing Outcomes in Nephrology Initiatives, committee member of ISN-Advancing Clinical Trials, deputy chair of ISN North and East Asia Regional Board, and deputy chair of ISN Education working group; and other interests/relationships as president of International Society of Renal Nutrition and Metabolism, committee member of ISN-Advancing Clinical Trials, member of Standardizing Outcomes in Nephrology Initiatives-HD Cardiovascular Disease Outcome Measures Working Group, member of SONG-PD Working Group, executive committee member of Standardizing Outcomes in Nephrology Initiatives, council member of International Society for Peritoneal Dialysis, deputy chair of ISN Regional Board, and deputy chair of ISN Education working group.

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Dietitians who provide nutrition care to kidney patients are limited around the globe and availability varies in countries, according to data published in Clinical Journal of the American Society of Nephrology.

Further, the availability of dietitians with or without renal experience decreases in countries with lower income.

Angela Yee-Moon Wang

Nutrition intervention is an important component of chronic kidney disease management that aims to improve clinical outcomes, optimize quality of life, and enable patients to continue participation and achieve life goals,” Angela Yee-Moon Wang, MD, PhD, from the department of medicine in Queen Mary Hospital at the University of Hong Kong in Hong Kong, and colleagues wrote. “With better understanding of current availability and capacity of global kidney nutrition care services, we hope to define service gaps and needs as well as challenges in meeting global needs. The findings of this survey form an important basis to identify future opportunities to improve global kidney nutrition care.”

The International Society of Nephrology (ISN) conducted the ISN Global Kidney Health Atlas project, a multinational cross-sectional survey aimed to measure current capacity for kidney care across the globe. A total of 182 countries with an affiliation to ISN were invited to participate in the electronic survey, and 160 countries responded.

Questions in the survey focused on current global availability of renal dietitians, capacity and cost of kidney nutrition care services. The survey also included questions about the communication between dietitians and nephrologists in the execution of kidney nutrition care.

Of the 160 countries that responded to the survey, 155 answered the kidney nutrition care questions, revealing that 75 countries have dietitians to provide kidney nutrition care to patients. The survey showed that countries with higher income levels were more likely to provide care. In fact, renal dietitians were generally unavailable in 65% of low or lower-middle income countries and “never” available in 23% of low-income countries.

Overall, 51% of the countries surveyed did not have dietitians trained specifically in nutrition service for renal care.

“In conclusion, this study demonstrates significant heterogeneity in global kidney nutrition care and suboptimal kidney nutrition care in many parts of the world, especially in lower income countries,” Wang and colleagues wrote. “The data call for a concerted effort to increase global advocacy for governmental allocation of resources and prioritization of kidney nutrition care services, to increase training of renal dietitians, to improve access to kidney nutrition care and to promote more structured interdisciplinary communication between nephrologists and dietitians to improve global kidney nutrition care.”

In a press release, Wang added, “In the long term, the definitive solution to the foregoing problem is to train and provide salary support for adequate numbers of qualified dietitians who have undergone specialized training in kidney nutrition to implement nutrition intervention across the spectrum of kidney disease. We hope this report will be an important advocacy tool to promote governmental prioritization and allocation of resources and manpower for this essential component in kidney care worldwide, especially in lower income countries.”

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