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Chronic Kidney Disease
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Medical Nutrition Therapy (MNT) provided by a registered dietitian (RD) is a comprehensive nutritional intervention which includes individualized nutrition assessment, diagnosis and therapeutic nutrition intervention and counselling. Its goal is to provide the patient with the tools necessary to adjust their diet and lifestyle to match their disease-specific needs. MNT remains among the most important interventions for slowing CKD progression and preventing dialysis. (5)
The Institute of Medicine (IOM) recommends MNT for patients with CKD and other chronic conditions like diabetes and hypertension since evidence demonstrates that MNT can improve clinical outcomes and ultimately health costs. (6)
5. Holly Kramer. Medical Nutrition Therapy for Patients with None Dialysis-Dependent Chronic Kidney Disease Barriers and Solutions. Medical Nutrition Therapy for Patients with Non-Dialysis-Dependent Chronic Kidney Disease: Barriers and Solutions. Journal of the Academy of Nutrition and Dietetics, Volume 118, Issue 10, 1958 - 1965
6. Institute of Medicine. The role of nutrition in maintaining health in the Nation’s elderly, Washington, D.C. National Academy Press. 2000.
MNT provides individualized nutrition therapy to control diabetes, hypertension, and other chronic conditions and delay the progression of CKD. (5)
MNT may include personalized eating plans, exercise, behavior change plans, and management of stress.
Medicare and most private insurances provide MNT coverage for persons with CKD or diabetes.
Medicare patients are eligible for 3 hours of face-to-face counselling during the first year and 2 hours for the subsequent years.
The treating physician must provide a referral for MNT and indicate the medical diagnosis (CKD or Diabetes).
Despite wide insurance coverage, MNT is underused; only 1 of 10 patient uses this benefit. (5)
According to a study conducted by De Waal et al and published in the Journal of Renal Nutrition in 2016, patients who received MNT from an RD with renal experience had better outcomes (slower progression to stage 5 and better laboratory values) than participants who did not receive MNT. (7)
The 2010 Evidence Summary of the Academy of Nutrition and Dietetics Evidence Analysis Library found good evidence supporting that MNT provided by an RD for adult patients with CKD is effective. (8)
7. De Waal, Desirée et al. Medical Nutrition Therapy for Chronic Kidney Disease Improves Biomarkers and slows Time to Dialysis Journal of Renal Nutrition, 2016, Volume 26, Issue 1, 1 – 9.
8. Academy of Nutrition and Dietetics Evidence Analysis Library. “ Is MNT provided by a Registered Dietitian for chronic kidney disease (CKD) in adults effective?” http://www.andeal.org/Accessed February 7, 2015.