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Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

Authors Beto JA, Schury K, Bansal V

Received 26 August 2015

Accepted for publication 23 October 2015

Published 2 February 2016 Volume 2016:9 Pages 21—33

DOI https://doi.org/10.2147/IJNRD.S76831

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Narender Goel

Peer reviewer comments 3

Editor who approved publication: Professor Pravin Singhal


Supplementary video presented by Katherine A Schury.

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Judith A Beto, Katherine A Schury, Vinod K Bansal

Division of Nephrology and Hypertension, Loyola University Healthcare System, Loyola University of Chicago, Maywood, IL, USA

Abstract: Chronic kidney disease (CKD) requires extensive changes to food and lifestyle. Poor adherence to diet, medications, and treatments has been estimated to vary between 20% and 70%, which in turn can contribute to increased mortality and morbidity. Delivering effective nutritional advice in patients with CKD coordinates multiple diet components including calories, protein, sodium, potassium, calcium, phosphorus, and fluid. Dietary intake studies have shown difficulty in adhering to the scope and complexity of the CKD diet parameters. No single educational or clinical strategy has been shown to be consistently effective across CKD populations. Highest adherence has been observed when both diet and education efforts are individualized to each patient and adapted over time to changing lifestyle and CKD variables. This narrative review and commentary summarizes nutrition education literature and published strategies for providing nutritional advice in CKD. A cohort of practical and effective strategies for increasing dietary adherence to nutritional advice are provided that include communicating with "talking control" principles, integrating patient-owned technology, acknowledging the typical food pattern may be snacking rather than formal meals, focusing on a single goal rather than multiple goals, creating active learning and coping strategies (frozen sandwiches, visual hands-on activities, planting herb gardens), and involving the total patient food environment.

Keywords: talking control, technology-enhanced learning, hemodialysis, nutrition education, education strategies

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