Advanced Nutritional Strategies for Patients With Renal Disorders

In this podcast episode, Lisa Jones, MA, RDN, LDN, FAND, interviews Kimberly Snodgrass, RDN, LD, FAND, a renal care coordinator at Fresenius Medical Care, on advanced nutritional strategies that dietitians can use when caring for patients with renal disorders, including using technology—such as a mobile app—to communicate with patients, and how dietitians can stay on top of emerging research in renal care. This episode is part three of a four-part series.

Listen to part one of this four-part series here. 

Listen to part two of this four-part series here. 

Listen to part four of this four-part series here. 

TRANSCRIPTION:

Moderator: Hello and welcome to Nutrition411: The Podcast, a special podcast series led by registered dietician and nutritionist Lisa Jones. The views of the speakers are their own and do not reflect the views of their respective institutions or Consultant360.

Lisa Jones, MA, RDN, LDN, FAND: All right, well we are back with Kimberly Snodgrass for another episode. We are talking today about beyond the basics, advanced nutritional strategies for renal care. Welcome back, Kim.

Kimberly Snodgrass, RDN, LD, FAND: Thank you so much for having me back.

Lisa Jones: Yeah. So we talked on a recent episode, we had a good chat about navigating challenges. We talked about dietary management of common renal conditions, and for those that didn't hear that episode yet, if you had to sum it up in one or two sentences, what would you say were the key takeaways from that episode?

Kimberly Snodgrass: That dieticians need to be utilized in preventative care and that we definitely need to use technology and have technology on our side. We only get to see our patients three times a week. So on the days that they're not there, we need to be able to touch base with them to make sure that they are following their diet. And that little encouragement and that extra step goes a long way. And having this technology, we need to use it. And our patients really appreciate when we contact them on their non-dialysis days just to say, I'm thinking about you. I just want to make sure that you're doing good. Do you have any questions? And on the next day we see them, they'll say, you know what? Thank you for reminding me about my fluid intake. I was just wondering about that, or My sodium and you touched base with me, kept me on track, and I just really appreciate that. So patients are appreciative when you think about them. So use technology for your advantage.

Lisa Jones: Yes. And that's so great that you do that because the other thing I think of too is who knows if you're the only touchpoint for them? Maybe they don't have family members and somebody reached out and cares, and that shows they care. And then they want to make sure that they're keeping up with their health and listening to what you're saying and following the guidelines and everything like that. So that's fantastic.

Kimberly Snodgrass: Absolutely.

Lisa Jones: Yeah. Thank you for sharing that.

Kimberly Snodgrass: Yeah, you're welcome.

Lisa Jones: Alright, so we're going to talk a little bit about the advanced nutritional strategies for renal care. And my first question for you, Kim, is what are some of the latest advancements in renal nutrition therapy? I know we talked a little bit about technology already. Is there anything else that you want to touch on about this area?

Kimberly Snodgrass: So yes, I do. So there's a thing called mobile health or mHealth, I'm not sure if you're aware of it. It's been titled as one of the special potential modalities to deliver nutrition care to (chronic kidney disease) CKD patients online with best practices. It's mHealth and it refers to the use of smartphone applications, mobile video conferencing, text messaging, and wearable devices to deliver healthcare directly to patients either synchronously or asynchronously. And they use it a lot during the COVID times because there wasn't a lot of ways to communicate with people without, you wanted to communicate with them, but you didn't always could see them face-to-face as much as you would like to because of the COVID virus. And so we used a lot of technology to communicate as much as we could. And when we took a survey with dieticians, when I looked at the research, it said the use of telehealth or nutrition care more than doubled during the pandemic. So that's awesome. And studies show that nutrition and dietetic care can be delivered using digital platforms and that it was endorsed by the Academy of Nutrition and Dietetics. So technology advancement is something that we have to keep abreast of. We can't fall behind as dieticians on technology because it's going to help us better service our patients.

Lisa Jones: Yes, that's certainly the case. And so with the technology, and I'm assuming the answer is the renal dietetic practice group, but where else can dieticians go? That's a lot to keep up with as you're a renal dietician. So do you have any other resources besides the dietetic practice group? How do they stay abreast of all this technology?

Kimberly Snodgrass: Well, the Academy of Nutrition and Dietetics offers the chronic kidney disease nutrition management certificate and training. And so it's a course that you can go through. It's not free. You have to pay for it through the academy. That's going to help train you with the chronic kidney disease population. And for those who want to actually sit for the exam to become certified specialists in renal disease, I've heard that this certificate training program in CKD really helps a lot. So you want to utilize all the Academy of Nutrition and Dietetics resources. You can go to eatright.org and it can lead to exactly where you need to be.

Lisa Jones: All right, perfect. Thank you for that. You're welcome. Let's talk a little bit about research. So the emerging research or studies, what are some that dieticians should be aware of in the field of renal nutrition? I know just research in general, there's so much to keep up with and I can't even imagine how much there is to keep up with in renal these days. So what are your thoughts on that?

Kimberly Snodgrass: Well, being in grad school, I research a lot. And so what I like to do is just be a part of a group, like the renal practice group because if there's something that I don't know, there's somebody in that group that's going to know what's going on. And so being able to be involved in different groups. There's one for weight management, there's one for renal disease, there's one for diabetes. Whatever specific disease population that you treat, you should be a part of that group because there's dieticians from across the country. And so you have a lot of knowledge in one space. And so I would say being a part of that group definitely has helped me grow as a renal dietician and get a lot of information that I couldn't just readily get on my own. So pulling it all together in one little small space.

Lisa Jones: So I like that bringing together a group, a group of minds, because having those conversations, I think that keeps you up to date on things too. And it's sometimes easier if somebody else has already been through the research and they can share that versus you trying to learn all of it yourself.

Kimberly Snodgrass: Exactly. And with me, I live in the city of Dearborn, Michigan where there's a high population of Arabic speaking patients. And so I chatted with somebody, they were able to give me information for an Arabic diet and just Arabic information so that when I go over the English part, I can also have the Arabic portion and we can just go through it together and just pictures with the fruits and vegetables. And so I can give that to the patient, and you just don't know how good it makes a patient feel when you went that extra mile and you have information that's specific for them. You know what I mean? So it really shows that you care and that you want to educate and you want that extra step. So being in that group is a wealth of resources that if you don't have it, someone else does.

Lisa Jones: Yes. And I think the group thing is really the ticket right there, like you said, staying, maintaining that connection and just the availability of resources. Because before, I guess the internet, you were limited the paper handouts that you would hand out. I don't know if you were practicing dialysis back then, it doesn't sound like it with the, do you still have some paper handouts or?

Kimberly Snodgrass: Do still have some paper handouts. I've actually been working in dialysis since 2004, so for a long time, a couple years I stepped away from it to do a couple other things. But kidney disease and renal disease, it's my baby. So you either love it or you don't is what people say. And I actually love it. And so I do, I keep a lot of my paper handouts just because I'm old school. And sometimes that's just the way I like to educate. And with having interns, it's nice to have papers, so that you can readily show in a binder or what have you.

Lisa Jones: Yeah, no, I appreciate that. I think that that's still has a place. I'm just wondering, just thinking back when I was in the unit, they didn't have anything like you're talking about it's in Arabic. They had nothing like that. It was pretty much, they didn't even have a Spanish handout back in the day.

Kimberly Snodgrass: Mmhm.

Lisa Jones: So now it's come so far. I'm just so impressed with what's happening today and how it's catered. It's very specialized. You're customizing it for that person. You're making them feel special. And I think that that's really, really important to do. And I love your group idea.

Kimberly Snodgrass: I have to agree with that. And patients, they take notice of that. You want somebody to care. You're going through this process, you're going through this time in your life. They can be very challenging, very hard. You're not in control anymore. And you definitely want someone to cater to your specific needs. And I feel like dieticians can do that. And I feel like we've come together as a group and we've done that. We've come a long way in the past, the 20 years that I've worked as a dietician, I've seen it go from just a regular standard plate of just regular foods to let's tailor for the Hispanic community and the Black community and this community so that everyone can be included in what they like to eat in a healthier way. And that means a lot. It speaks volumes. And I'm glad that the academy has helped a lot with that as well.

Lisa Jones: Yeah, they definitely have. And then the other thing I think of too is to what we were talking about, you're not just a number. The patient doesn't feel like they're a number. They're just another person here filling a chair type thing.

Kimberly Snodgrass: No, I agree. They're like family, honestly. With them coming in, they become your family and you care that much. I mean, and it could be your mother or your father on the dialysis machine, and you want to treat them with respect and care and make sure that you're reviewing the diet and the labs and just applying all the knowledge and expertise that you learned over the years in school and through your internship.

Lisa Jones: Yeah, such a great point. Such a great point for all our listeners to hear, too. And I'm sure everyone, all the dieticians that are working in this space are doing the same thing. And yeah, it's just nice to know that we're all on the same page and doing what dieticians do. Right?

Kimberly Snodgrass: Yeah. We all cut from the same cloth pretty much.

Lisa Jones: Yeah! Alright, so talking a little bit further, I know we already touched on a little bit of the education resources when we were talking about some of the examples earlier, but what other continuing education resources are available for dieticians that specialize in renal nutrition? And you mentioned quite a few, so if there isn't any that come to mind or if you just want to revisit one you've already talked about, that's fine too.

Kimberly Snodgrass: Well, there isn't one that specifically comes to mind. The only thing that I can really think about pretty much is the renal practice group, which I am in through the academy, and just anything that the academy can put out, getting your certification or going to one of their certificate trainings, that's what I lean towards. Those things that are more standard and that I know about. So those specifically have helped me and I've had a mentor. I think that every dietician, especially starting out, should have a mentor. Somebody that you can go to bounce ideas off, talk to things about patient care, different diets, your career growth, just so that they can walk you through that process. So that's important. I think that's really key.

Lisa Jones: Yeah, definitely a mentor. Definitely agree with that. Well, thank you for your wealth of knowledge on this episode.

Kimberly Snodgrass: You're most welcome.

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