DaVita Medical Insights

Honoring Dietitians on National Dietitian Day

Let food be thy medicine and medicine be thy food

–Hippocrates

We are what we eat. This statement, uttered many times, is an inevitable truth. Our food and liquid intake is critical for maintaining the balance of the right proteins and additional nutrients for our body to function best and to provide the energy that we need to move our muscles, to breathe and even to think. Maintaining this balance can be particularly difficult for people who develop chronic kidney disease (CKD): They experience subtle changes in how they handle, metabolize and get rid of or excrete foods and liquids, and those changes become more prominent over time as their CKD progresses to kidney failure. The changes involve more than simply developing an inability to get rid of excess fluid—the body must also figure out how to maintain energy intake for muscles. The dietary requirements that come with these changes are challenging for patients. Foods that might help either don’t taste as good as they did in the past or may cause a metabolic imbalance in some way. And whereas there were few, if any, consequences for over-indulging previously, now with CKD, that carte blanche is gone.

Who are the understanding people who help patients navigate through this maze of new dietary information?  Who can provide them with ideas, insights and tips for healthy eating and drinking with CKD or kidney failure?  They are our dietitians. The foundational degree and certification required to become a registered dietitian (and very often one degree on top of that) exposes dietitians to food science, nutrition, public speaking, chemistry, mathematics, physiology, psychology, purchasing, sanitation, nutritional aspects of disease and much more. These incredible individuals have a keen sense of organizational dynamics and individual human psychology. And we are incredibly fortunate to have them as our teammates.

Our dietitians complete nutritional assessments on all of our patients. These assessments are extensive and include patient information such as height, weight, medications and mobility, as well as specific food-related information such as appetite, food preferences, nutritional concerns and more. They deliver patient-centered education around laboratory values; an appropriate diet for patients with kidney disease; recipes and tips for cooking at home or eating out; and individualized guidelines for patients based on appropriate intake of phosphorus, potassium, sodium, fluid and more. Patients may at times not be enthusiastic about following dietary recommendations. This is where the art of the dietitian is witnessed, day in and day out. In fact, it could be said that everyone involved in nutrition support is really at the forefront of shared decision making with patients and the care team.

The often quiet work of our dietitians is of tremendous significance for our patients and how they function with their kidney disease. Dietetics in CKD is recognized as important not just by us, but by the federal government, which requires evaluation of nutritional status by a dietitian as part of the patient plan of care per the Conditions of Coverage for End-Stage Renal Disease Facilities. March 8 is National Dietitian Day, part of the ongoing events of Nutrition Month in March. This is a great opportunity to take a moment and recognize our teammates involved in nutrition services. They do something unique and beneficial for patients as they help them manage the transitions of kidney disease on a constant basis.

Bryan Becker, MD, MMM, FACP, CPE

Bryan Becker, MD, MMM, FACP, CPE

Bryan N. Becker, MD, is chief medical officer of DaVita Integrated Care and has nearly 20 years of physician executive experience. He received his AB in English at Dartmouth College and MD from the University of Kansas, and, after training at Duke and Vanderbilt, he led the nephrology group at the University of Wisconsin and developed a new kidney care venture called Wisconsin Dialysis, Inc. He also served as CEO at the University of Illinois Hospital and Clinics and president of the National Kidney Foundation. Before joining DaVita Kidney Care, Dr. Becker served as President of the University of Chicago Medicine (UCM) Care Network, a more than 1,000 physician clinical integration organization, and Vice President, Clinical Integration and Associate Dean, Clinical Affairs at UCM.