KidneyRD.com (online renal dietician?)

[Skeptix]

Anyone heard of or used this company? Looks to be an online rather than face to face dietician operation.

[Hidden]

I've never heard of them. I did check out their website. It appears as though they came together in 2021. I wasn't impressed with them and there was no mention of cost or what insurance they accepted. Have you thought of going to your local hospital or dialysis center and seeing who they use? I have recommended going to eatright.org and search for an RD.

If you use this new place, let us know what you think.

[Skeptix in reply to Hidden]

An RD is problematic in Ireland. Hard to find unless it's ESKD territory you're in. This info coming from my nephrologist and me finding it so in practice.

Someone here suggested trying online which makes sense as diet is the kind of thing which lends itself to that medium..

[orangecity41 NKF Ambassador]

I had heard of this and they do offer a on line class, which tells you also how much potassium and phosphorus and sodium you should have. Caution: we can be different on what and how much we can have in a CKD diet. My Doctor prescribed a diet that told how much of these I can have. Perhaps ask your Doctor about this web site.

[Skeptix in reply to orangecity41]

I don't know what docs are like in the US (if that's where you are speaking from) but I wouldn't be happy relying on a doc here in Ireland (and I've shifted a few times to get a doc who doesn't whizz you through your visit, stuffing a prescription in your back pocket as they usher you out the door. "€65 thank you" )

Even my nepbrologist seems very lax - it was me who suggested (a year ago) bumping ACE from 5mg to 7.5mg to lower BP a bit more. Then again recently suggesting 7.5mg to 10mg. "Oh well, yes, I suppose so" WTF.

[orangecity41 NKF Ambassador in reply to Skeptix]

Maybe this web site is the best you can do.

[Darlenia in reply to Skeptix]

Honestly, the renal dieticians aren't all that great in the US either, particularly if you have underlying conditions such as diabetes. Ours was pushing rice, sweet fruits, breads, etc. that only drive up glucose harming kidneys further. We mentioned that and she candidly said she didn't know too much about that and later sent us materials she found on the internet to help us out. Even our diabetes prone nurse at the dialysis center mentioned the need for more educated renal-diabetes trained dieticians as "almost all" there receiving dialysis have diabetes. But, bottom line, most people turn to the internet to provide information. The internet, frankly, is the greatest repository (good and bad) in the world. It's there to use wisely - with discrimination, it can be powerful tool for wellness.

[Skeptix in reply to Darlenia]

But isn't diabetes (and blood pressure) one of the core causes of CKD? How the hell can a renal dietician say they don't know much about that? Or is it the case that their focus is nutrition at ESRD where they are taking a near-palliative care approach? Good grief!

[horsie63 in reply to Skeptix]

I think it comes down to people on dialysis have different nutritional needs than someone who wants to improve/stabilize and avoid dialysis until absolutely necessary and as such those people (like us not on dialysis) aren't the money makers. And it's not just in healthcare but across the board everywhere, if you aren't providing $$$ then you don't really count.

[Bassetmommer NKF Ambassador]

I took a look at the website and was completely amazed. S much so I am going to look into some of their classes. What a great find. Will have to do a much deeper dive into it but I am impressed. Thanks for the link.

[Skeptix in reply to Bassetmommer]

What impressed you about it? I've booked into their next webinar so will see how it goes. Be interested in finding out what help a dietician can be and how much bang per buck they can offer me.

You'd have thunk that your bloods and tracking your nutrient intake (on, for example the anally-retentive Cronometer would give you the information you need to know that you are on track dietary-wise.

At least KidneyRD appear to be open to the idea of preserving what you've got on the slide down from stage 3

[Bassetmommer NKF Ambassador in reply to Skeptix]

I was impressed with the options, the plant based and the classes for dieticians. The prices seem reasonable. And I also like the positive vibe that there is hope.

[Skeptix in reply to Bassetmommer]

Yeah picked upon the vibe. Xtreme Focus on preserving wot you got doesn't seem to feature heavily in medics I've encountered thus far.

It'll be interesting what they have to say re Lee Hull's view of going on a vlpd + keto at stage 3.

[lowraind]

I am familiar with Kidney Grub, which my daughter researched in 2017. I have used their recipes.

[Skeptix in reply to lowraind]

That's from KidneyRD I gather.

I'm less fussed about recipes at the moment (you can use Cronometer to track your nutrients) and more about what's the best overall approach.

Currently on a vlpd with keto (Lee Hull's approach) with Cronometer to help me track nutrients so that I don't seriously fall short. If someone could make a case for some meat that'd be great: it's bloody hard to keep protein to 25g day (0.4g/kg) on a vlpd. But they'd have to convince me, given the science indicating a no-meat-at-all is the way to go.

(Truth be known, besides the fact that I've cut out meat and dairy (I am permitted the odd omelette - I cheat Lee and have 1 egg yoke sneaking into 2 x egg whites) my diet is a 1000% improvement on whatever went before in my life. There was no way I was getting the level of nutrients on board that I'm getting now with all this fruit and veg.

[Skeptix]

Interestingly, the founding renal dietician behind KidneyRD.com cites reading Lee Hull's book as contributing to an epiphany which has led her to break away in a new diet-led direction. She describes her formal experience as a renal dietician as symptom treating rather than preservative and preventive.

And agrees with Lee Hull's statement that moderation kills!

She says:

"Shift #2 came because of a perfect storm of experiences recently. These include books and articles I’ve read, discussions with leaders in the field, and my own experiences with clients. Here’s a few bits from that storm that changed my mind:

I appreciate the passion and thoroughness of Lee Hull’s book, Stopping Kidney Disease. This piece from his book spoke to what I had observed with MRT and LEAP therapy and also what I was thinking about for my own clients with kidney disease:"

[JohnInTexas]

I too am not familiar however use an RD that utilizes tele visits to accomplish kidney friendly diets/menus/portion control. I found Up4Nutrition.com (Plano, TX) through eatright.org and they are approved by my secondary insurance carrier. The RD tele-visits saves me fuel/time for going to critical Kidney Specialist appointments and Medicare, in my case, covers 100% of the RD Tele-visits. I've remained stable in Stage 3 CKD after a urinary blockage remedied by Urological surgery cleared the plumbing backup however the kidney damage was already up to Stage 3A by the time my team of specialist found the root cause. Good luck!

[Skeptix]

I followed up with kidneyRD.com and can report the following:

- Started out with a webinar in which they laid out their global positions on diet and CKD. They also skimmed over the kinds of service they offer. Some useful bits of info but probably nothing much new for anyone who was reasonably well informed from say, coming on here.

- Stemming from that the offer of a 20 min personal phone call with Jessiana, seemingly the lead renal dietician. Easy going conversation where she listened to what I had to say and where I was. There was no hard selling a particular approach. There didn't seem to be an issue with tailoring things to suit what I felt I needed.

(Although eGFR 30+, I've no symptoms and very little out in my bloods. I was thinking along the lines of a renal dietician to "cover my back" in my wandering along the very low protein + keto acid analogue path. I don't want to drop major balls. This would suit me, rather than having a renal dietician hold my hand and give me meal plans and the like).

- contra to what you hear a lot of on here regarding peoples experiences, they are up to speed on low and very low protein + keto acid analogue approaches starting at earlier stages of the disease than late 4 or 5.

- they don't take insurance and it's not exactly a cheap service. You could drop $1000 on a package involving say 5 consultations/reviews.

Overall, she came across as personable, knowledgable and genuine. A potentially good resource if you need it and can afford it.