Renal Telenutrition for Kidney Health: Leveraging Telehealth and Telemedicine for Nutritional Assessment and Dietary Management of Patients With Kidney Disorders

Chronic kidney disease

“…196 In order to maintain staffing levels and to protect patients, outpatient CKD care has undergone a radical transformation by using telemedicine, remote care and minimising blood testing to those tests that guide dietary and therapeutic decisions. 197 Advance care planning and ensuring completion of renal replacement therapy modality plans are of even higher importance, as COVID-19 can cause AKI, which could be due to septic shock and cytokine release or from direct renal tropism of the virus. 198,199 The disproportionately high incidence of AKI requiring frequent or continuous renal replacement therapy in critically sick patients with COVID-19 may have implications for long-term kidney longevity in COVID-19 survivors, Ongoing and future trials are expected to address these questions including as to whether ACE-receptor modulators or other modulators of kidney function can avert COVID involvement in AKI and CKD progression.…”

Functional Nutrition, Naturopathic Nutrition, and Integrative and Holistic Renal Nutrition in Kidney Health and Value-Based Kidney Care Models

“…16 PLADO diet regimens including PLAFOND should be provided under MNT with periodic review of renal dietitians that can be in the form in-person visits or telenutrition. 23 Integrative and functional nutrition is an area of renal nutrition and dietetics practice in which critical thinking skills of renal dietitians are especially important to achieve and maintain the expected level of consistency in providing kidney nutrition care and utilizing evidence-based guidelines and emerging scientific data when available. Given limited evidence-based practice guidelines for functional nutrition in renal care, renal dietitians should use critical thinking skills to appraise the available scientific literature in the context of real-world practice scenarios in kidney care including in the context of emerging value-based kidney care models.…”

Practicing health equity in involuntary discharges to overcome disparities in dialysis and kidney patient care

“…For instance, the National Forum of the ESRD Networks, including its Medical Advisory Council consisting of representatives of the Medical Review Boards of all 18 Networks, and its Kidney Patients Advisory Council, in collaboration with the ESRD NCC, AHRQ, and 14 other stakeholders, should create patient–provider collaboration and practicing health equity toolkits. Both de novo created and amended preexisting toolkits of these organizations should meet the contemporary needs and emerging challenges of the dialysis programs including those related to greater use of telehealth [37] and social media [38]. Programs should be designed to educate all members of a dialysis facility's staff, with the goal of bridging the knowledge gap and improving effective communications.…”