Renal Dieticians

[dxbf]

I'm jumping the gun here because I haven't even talked to my doctors about finding a dietician yet - hopefully they can refer me to someone. But I've Googled as I like to do and I'm not seeing anyone. I live in a big city with lots of doctors but I only find about four or five registered dieticians, and their websites are all about weight loss and general nutrition advice - not a single one who mentions kidney disease.

If you have a renal dietician, how did you find them? Do they take Medicare? I saw somewhere that if you're stage 3B Medicare will cover a dietician, but where are they? Even the Medicare directory only shows one in all of San Francisco. But I will pay out-of-pocket if need be.

I have some digestive problems that have limited what I can eat - I've been feeling better on high protein and limited grains and vegetables and no beans. I don't see how I can adapt this to be kidney-healthy. I'm going to definitely need help.

[Hidden]

Hi,

You might want to contact any of the dialysis centers in the Bay area and ask them for names of RD's. Also, any of the hospitals in the Bay area would be excellent places to contact for help. If it were me, and you had to call hospitals, I would call USF first.

I had to drive almost two hours to meet with my RD. After the first two visits, we use e-mails to keep in contact. If any significant changes occur with my numbers or some other change may be required, I send her an e-mail with the important numbers from my labs, protein, potassium, phosphorus, sodium, calcium, GFR, Vitamin D, etc. and she suggests a temporary or permanent change to my meal plan.

I recently had my gallbladder removed and contacted her just prior to the procedure and after reviewing my current meal plan on file she made one suggestion and I was good to go.

My previous insurance company covered the first two visits. The e-mails are a courtesy and should any significant changes need to be made I would have to drive to her office.

In addition to helping develop a kidney-friendly meal plan she also provided me with information on a couple of doctors who do the surgery needed for dialysis prep.

Best of luck with the search.

[Bassetmommer NKF Ambassador]

HI Dxbf,

I would check with your nephrologist. Also, is there a dialysis center near you. They should have a list of renal dieticians. You want someone trained in renal function nutrition.

You can start on your own by Googling what the recommendations are. There is a lot of information out there. Davita.com is good and the National Kidney foundation also has tons of information. But you will want someone to tailor a plan for you. Check to see if the NKF local office has anyone to recommend.

At stage 3b, I am going to offer the advice ( and only advice) that you start with cutting back immediately on the high protein consumption. Start small, like having at least one meal without meat. I am assuming that is what your protein consumption is from. What you are saying you eat is totally counter to a kidney friendly diet.

I know it is hard to break a habit, especially diet. But you have control of this. Since you have other dietary conditions, it is imperative you find the dietician. I googled this website and see if this will help. It has a couple in the SF area

healthprofs.com/us/nutritio...

[KidneyCoach NKF Ambassador]

Contact a dialysis clinic near you talk to them by phone. Go from there.

[FlowerPreciousLover]

I found myself in a very similar situation; large city but no lists of renal dieticians. It took 4 requests over a period of months to pcp and nephrologist to get a referral to a "regular dietician" .

I was fortunate that my Medicare Advantage ins. covered the visit although it would have been well worth the out-of-pocket cost of $300 if private pay had been required.

The dietician gave me combined diabetes & CKD handouts to follow and counseled me on how a daily meal plan might look along with suggested calorie intake of carbs, protein etc.

Suggest taking your lab reports with you for the dietician to review when you go.

In the interim, so agree with what Bassetmommer wrote that going to some trusted sites can also get you started in modifying your diet. The changes I made with renal diet before seeing the dietician improved my GFR score from 54 to 68.

Think most here will agree that renal and other chronic diet changes are one of the hardest to make initially but the dividends pay off with improved lab results. Best wishes.

[dxbf]

Thanks to everyone for your very helpful suggestions - I think I know now how to proceed with this when I'm ready.

Unfortunately, at the moment all I can digest well is protein, so the kidney diet will have to wait. My GI doc pretty much gave up on me, but she did refer me to someone she thought might be able to help. I'm keeping my fingers crossed that he can.