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Kidney Specialists Reluctant to Recommend Plant-Based Diets Despite Benefits

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Kidney Specialists Reluctant to Recommend Plant-Based Diets Despite Benefits

Kidney-focused healthcare professionals often don’t recommend a plant-based diet to their patients with chronic kidney disease due to concerns about patients’ willingness to follow through with such recommendations, according to the results of a new survey presented at the National Kidney Foundation Spring Clinical Meetings.

Chronic kidney disease is a common long-term diabetes complication, and diabetes is the leading cause of the condition, which is characterized by worsening kidney function over time. Eventually, many people with chronic kidney disease need to undergo regular dialysis to remove waste products from their blood, when their kidneys can no longer adequately do so. Some people with the condition receive a kidney transplant, which may reduce or eliminate the need for dialysis.

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As noted in a Healio article on the survey and meeting presentation, the lead researcher — Melanie Betz, RD, LDN, a chronic kidney disease nutrition and education specialist at University of Chicago Medicine — designed the survey to gain a better understanding of how often plant-based diets are adopted by people with chronic kidney disease, and what the barriers are to more healthcare providers recommending this way of eating. Plant-based diets — which don’t have to be free of all animal products, but which emphasize healthy plant foods — have been shown in many contexts to help slow the progression of chronic kidney disease, in part because high protein intake can be damaging to kidney health in people with reduced kidney function.

For the survey, researchers gave questionnaires to 657 healthcare professionals, out of which 58% were registered dietitians and 53% worked with dialysis patients. They also surveyed 844 people with chronic kidney disease, out of which 35% were not dependent on dialysis and 35% had received a kidney transplant. Questions for patients were designed to assess awareness of the benefits of plant-based diet, and to learn whether they had ever had such a diet recommended to them by a healthcare provider.

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Plant-based diets not often recommended

Among healthcare providers, the survey found that 79% believed that a plant-based diet can be an effective lifestyle modification for people with chronic kidney disease. But only 56% of these same providers said they had recommended such a diet to their patients. The top reason providers gave for not recommending this way of eating wasn’t related to any health concerns — instead, it was that patients were unlikely to accept the recommendation, or that following it didn’t strike them as realistic.

For kidney disease patients, the survey found that most people were unaware of the benefits of a plant-based diet for kidney health and didn’t perceive following it to be a recommendation from healthcare providers. They reported that the top barriers to following such a diet were the food preferences of their families, their personal preference for meat, and difficulty planning plant-based meals.

Betz noted that based on these survey results, it may be important for healthcare providers to frame the issue of a plant-based diet not as an all-or-nothing approach, but as a recommendation to guide your meal choices. Even eliminating a couple of meat-based meals each week, she noted, may have a meaningful impact on slowing the progression of chronic kidney disease. The survey results also showed that both healthcare providers and patients believed that counseling sessions are the most effective way to increase acceptance of a plant-based diet, so dietitians, in particular, shouldn’t hesitate to raise this topic.

And another effective strategy may be to discuss plant-based diets not in general terms about being good for kidney health, but as a way to slow kidney disease progression and potentially avoid dialysis. Most people with chronic kidney disease, Betz noted, are eager to avoid this outcome and may be more receptive to recommendations when offered in this context.

Want to learn more about keeping your kidneys healthy with diabetes? Read “How to Keep Your Kidneys Healthy,” “Kidney Disease: Your Seven-Step Plan for Prevention” and “Ten Things to Know About Kidney Disease.”

Living with type 2 diabetes? Check out our free type 2 e-course!

Quinn Phillips

Quinn Phillips

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A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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