Heterogeneity Identified in Global Kidney Nutrition Care

Angela Yee-Moon Wang, M.D., Ph.D., from The University of Macau, S.A.R., China, S.A.R., China, and colleagues administered an electronic survey among key kidney care stakeholders through 182 International Society of Nephrology-affiliated countries between July and September 2018.

Overall, 155 of the 160 countries that responded answered the survey items relating to kidney nutrition care. The researchers found that only 48 percent of the 155 countries have dietitians/renal dietitians to provide kidney nutrition care. Dietary counseling provided by a person trained in nutrition was generally not available and never available in 65 percent of low/low-middle income countries and 23 percent of low-income countries, respectively. Formal assessment of nutrition status for kidney nutrition care was not provided in 41 percent of the countries. There was global variation in the availability of oral nutrition supplements; for both inpatient and outpatient settings, they were mainly unavailable in low/lower-middle income countries. In 60 percent or more of countries, dietitians and nephrologists only communicated sometimes on kidney nutrition care.

"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," the authors write.