Leveraging Medical Nutrition Therapy to Slow the Progression of Chronic Kidney Disease

CKD affects 37M adults in the US and costs Medicare $120B dollars to treat each year. While the costs for treating end-stage renal disease (ESRD) are high, outcomes are still poor for those on hemodialysis (HD) and waiting on transplants. About one in five treated with the dialysis treatment, hemodialysis (HD), die within a year of starting it and nearly 5K people die each year waiting on a kidney transplant.

In order to improve outcomes and save on costs associated with CKD and ESRD, several challenges with care must be addressed. One area that is proving to slow the progression of CKD is Medical Nutrition Therapy (MNT).

On September 10th, Jumpstart Associate Gabe Laurence sat down with RxDiet Founder Roman Kalista, MD to discuss how MNT is making strides to alleviate the costs and slow the progression of CKD.

In the webinar they discussed;

• The definition of MNT and how utilization can slow the progression of CKD
• How diet changes depending on the stage of CKD
• The effectiveness of MNT
• How RxDiet is eliminating the barriers to MNT

Highlights from the Webinar

The Definition of MNT And How Utilization Can Slow The Progression of CKD

MNT a series of patient interactions where a provider works to implement the right nutritional habits with the patient to improve their health. Roman notes that MNT can slow the progression of CKD because “CKD is largely influenced by diet, especially because the main causes for CKD are high blood pressure and type two diabetes. And both of those conditions are very responsive to right dietary therapy. And therefore, we can then influence the progression of CKD as well”. 

How The Optimal Diet Changes Depending on of Stage CKD

Roman notes that diet absolutely should change depending on the stage of CKD. He clarifies by saying “ what they’re trying to do in Stage 1 through 4 is really maintain the kidney function and eat the diet that is very suitable for kidneys such as…low in protein, high in complex carbohydrates, low in saturated fats and cholesterol”. Roman then goes on to note “in stage five, our goals become very different. So stage five end stage renal disease is all about survival. So we’re…doing the exact opposite actually. So we’re trying to pump as much protein into our patients as possible. We’re trying to increase the calories because high body mass index on dialysis means higher survival”. 

The Effectiveness of MNT

When discussing the effectiveness of MNT, the literature backs up MNT. Where Roman notes that things go wrong traditionally is in patient engagement and a lack of prescription of MNT. Roman comments, “ from Medicare data for diabetes patients, which are virtually very similar to our CKD patients, we know that only 0.6% of these patients have received medical nutrition therapy, even though it is the number one step in management of diabetes and CKD”. 

How RxDiet is Eliminating The Barriers to MNT

Currently there are a few different barriers that prevent patients from utilizing MNT. Roman notes that currently we can tell patients what they should be eating, but the traditional system does not make it easy for patients to actually begin making those changes. There are four main barriers according to Roman, “first education, and [second] it was planning the right meals, [third] shopping for the right grocery products, and [fourth] then managing costs”.

Roman is addressing all of these problems with RxDiet as “our AI is actually capable of incorporating all of those problems into a large mathematical equation and optimize not only nutrition, but can also connect to retail outlets online, analyze the grocery products, pick the right grocery products and combine them in such an efficient way that we’re reaching extremely low cost, usually under $3 per meal”. 

If you are interested in learning more about RxDiet, please reach out to Roman at roman.kalista@rx-diet.com.