Abstract
Background and objectives Nutrition intervention is an essential component of kidney disease management. This study aimed to understand current global availability and capacity of kidney nutrition care services, interdisciplinary communication, and availability of oral nutrition supplements. Design, setting, participants, & measurements The International Society of Renal Nutrition and Metabolism (ISRNM), working in partnership with the International Society of Nephrology (ISN) Global Kidney Health Atlas Committee, developed this Global Kidney Nutrition Care Atlas. An electronic survey was administered among key kidney care stakeholders through 182 ISN-affiliated countries between July and September 2018. Results Overall, 160 of 182 countries (88%) responded, of which 155 countries (97%) answered the survey items related to kidney nutrition care. Only 48% of the 155 countries have dietitians/renal dietitians to provide this specialized service. Dietary counseling, provided by a person trained in nutrition, was generally not available in 65% of low-/lower middle–income countries and “never” available in 23% of low-income countries. Forty-one percent of the countries did not provide formal assessment of nutrition status for kidney nutrition care. The availability of oral nutrition supplements varied globally and, mostly, were not freely available in low-/lower middle–income countries for both inpatient and outpatient settings. Dietitians and nephrologists only communicated “sometimes” on kidney nutrition care in $60% of countries globally. Conclusions This survey reveals significant gaps in global kidney nutrition care service capacity, availability, cost coverage, and deficiencies in interdisciplinary communication on kidney nutrition care delivery, especially in lower-income countries.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 38-52 |
| Number of pages | 15 |
| Journal | Clinical Journal of the American Society of Nephrology |
| Volume | 17 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2022 |
Keywords
- Cross-Sectional Studies
- Dietary Supplements
- Global Health
- Health Care Surveys
- Humans
- Kidney Diseases/therapy
- Nutrition Therapy
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Nephrology
- Transplantation
- Epidemiology
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In: Clinical Journal of the American Society of Nephrology, Vol. 17, No. 1, 01.2022, p. 38-52.
Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Assessing Global Kidney Nutrition Care
AU - Wang, Angela Yee Moon
AU - Okpechi, Ikechi G.
AU - Ye, Feng
AU - Kovesdy, Csaba P.
AU - Brunori, Giuliano
AU - Burrowes, Jerrilynn D.
AU - Campbell, Katrina
AU - Damster, Sandrine
AU - Fouque, Denis
AU - Friedman, Allon N.
AU - Garibotto, Giacomo
AU - Guebre-Egziabher, Fitsum
AU - Harris, David
AU - Iseki, Kunitoshi
AU - Jha, Vivekanand
AU - Jindal, Kailash
AU - Kalantar-Zadeh, Kamyar
AU - Kistler, Brandon
AU - Kopple, Joel D.
AU - Kuhlmann, Martin
AU - Lunney, Meaghan
AU - Mafra, Denise
AU - Malik, Charu
AU - Moore, Linda W.
AU - Price, S. Russ
AU - Steiber, Alison
AU - Wanner, Christoph
AU - Wee, Pieter Ter
AU - Levin, Adeera
AU - Johnson, David W.
AU - Bello, Aminu K.
N1 - Funding Information: A.K. Bello reports receiving honoraria from Amgen, Janssen, and Otsuka and serving as an associate editor of Canadian Journal of Kidney Health and Disease and as cochair of ISN GKHA. K. Campbell reports serving as a scientific advisor or member of Dietitians Australia and being employed by Metro North Hospital and Health Service. S. Damster reports being employed by ISN. D. Fouque reports serving as an advisory board member of Astellas, AstraZe-neca, Lilly, and Sanofi; having consultancy agreements with Astra-Zeneca, Astellas, Fresenius Kabi, Lilly, and Sanofi; receiving honoraria from AstraZeneca, Fresenius Kabi, Lilly, and Sanofi; serving as a scientific advisor or member of AstraZeneca, Kabi, and Sanofi; receiving lecture fees from BBraun, Fresenius Kabi, and Vifor; and receiving research funding from Fresenius. A.N. Friedman reports having ownership interest in Eli Lilly; serving on editorial boards for Frontiers in Nephrology and Journal of Renal Nutrition, as a scientific advisor or member of GI Dynamics Scientific Advisory Board, and as a council member of the ISRNM; having consultancy agreements with Goldfinch Bio; and having other interests in/relationships with Watermark Research Partners by serving as a data safety and monitoring board (DSMB) member. G. Garibotto reports serving as a scientific advisor or member of editorial boards for BMC Nephrology, Journal of Clinical Medicine, Journal of Nephrology, and Journal of Renal Nutrition; having consultancy agreements with Fresenius Kabi; and serving as secretary and a council member of ISRNM. F. Guebre-Egziabher reports serving as a member of the Ethio-American Doctors Group, as a board member of the Ethio-American doctors fund, and as a member of the Francophone Society of Nephrology, Dialysis and Transplantation. D. Harris reports serving as past president of ISN. K. Iseki reports receiving honoraria from Bayer, Chugai, Daiichi Sankyo, Genzyme Japan, Kyowa Hakko Kirin, Otsuka, and Teijin; having consultancy agreements with HekaBio Inc. and Kyowa Hakko Kirin; and being employed by Nakamura Clinic. V. Jha reports receiving honoraria from Astra-Zeneca, Baxter Healthcare, and NephroPlus; receiving grants from Baxter Healthcare, Biocon, and BSK; receiving research funding from Baxter and GlaxoSmithKline; being employed by the George Institute for Global Health India; and serving as a scientific advisor or member of NephroPlus. K. Jindal reports receiving research funding from Amgen and Rockwell and honoraria from Amgen, Boehringer Ingelheim, and Lilly. D.W. Johnson reports serving as a scientific advisor or member of American Journal of Kidney Disease, CJASN, Cochrane Kidney and Transplant Group, National Health and Medical Research Council Academy, and Peritoneal Dialysis International; receiving travel sponsorships from Amgen; having other interests/relationships with Amgen (accommodation sponsorship), Australian and New Zealand Society of Nephrology (as president), International Society for Peritoneal Dialysis (ISPD; immediate past president), ISN (as past councillor), and Kidney Health Australia (advisor); having consultancy agreements with AstraZeneca, AWAK, Bayer, and Lilly; serving as Australian and New Zealand Society of Nephrology Councillor, the immediate past president of the International Society of Peritoneal Dialysis, and past ISN councillor; being a current recipient of an Australian National Health and Medical Research Council Practitioner Fellowship; receiving research funding from Baxter and Fresenius; serving on speakers bureaus for Baxter Healthcare and Fresenius Medical Care; receiving consultancy fees, research grants, speaker’s honoraria, and travel sponsorships from Baxter Healthcare and Fresenius Medical Care; receiving honoraria from Baxter, Fresenius, and Ono; and receiving speaker’s honoraria and travel sponsorships from ONO. K. Kalantar-Zadeh reports receiving honoraria and/or support from Abbott, Abbvie, ACI Clinical (Cara Therapeutics), Akebia, Alexion, Amgen, Ardelyx, AstraZeneca, Aveo, BBraun, Chugai, Cytokinetics, Daiichi, DaVita, Fresenius, Genentech, Haymarket Media, Hospira, Kabi, Keryx, Kissei, Novartis, Pfizer, Regulus, Relypsa, Resverlogix, Sandoz, Sanofi, Shire, Vifor, UpToDate, and ZS-Pharma; serving as a scientific advisor or member of Abbott, Abbvie, American Journal of Kidney Diseases, American Journal of Nephrology, Amgen, Ardelyx, AstraZeneca, Aveo, Cardiorenal Medicine, CJASN, Daiichi Sankyo, DaVita, Fresenius, Genetech, Hospira, International Urology and Nephrology, JASN, Journal of Renal Nutrition, Journal of Cachexia, Sarcopenia and Muscle, Keryx, Kidney International, Kidney International Reports, Nature Reviews Nephrology, Nephrology Dialysis Transplantation, several National Institutes of Health (NIH) study sections, National Kidney Foundation (NKF), Relypsa, Resverlogix, RUN, Sanofi, Seminars in Dialysis, Shire, Vifor, and ZS-Pharma; receiving honoraria from Abbott, Abbvie, Amgen, American Society of Nephrology, Ardelyx, AstraZeneca, Aveo, Baxter, Daiichi Sankyo, DaVita, Fresenius, Genetech, Hospira, Keryx, NIH, NKF, Relypsa, Resverlogix, Sanofi, Shire, Vifor, and ZS-Pharma; having consultancy agreements with Abbott, Abbvie, Amgen, Ardelyx, AstraZeneca, Baxter, Daiichi Sankyo, Fresenius, Hospira, Keryx, Otsuka, Resverlogix, Sanofi, Shire, and Vifor; receiving research funding from Dexcom and NIH; serving on speakers bureaus for Akibia, Daiichi Sankyo, Fresenius, Keryx, Relypsa, Sanofi, Shire, and Vifor; and having patents and inventions involving prognostic assays for maintenance hemodialysis patients. B. Kistler reports receiving research funding from Academy of Nutrition and Dietetics and serving as a scientific advisor or member of Academy of Nutrition and Dietetics, ISRNM, and Journal of Renal Nutrition. J.D. Kopple reports having other interests/ relationships with Alpha Omega Alpha, American College of Physicians, American Society for Clinical Investigation (Emeritus), American Society for Nutrition, American Society of Nephrology, Association of American Physicians, International Federation of Kidney Foundations, International Society for Renal Nutrition and Metabolism, ISN, and NKF; having consultancy agreements with, having ownership interest in, receiving honoraria from, and serving as a scientific advisor or member of Nephroceuticals; and receiving a research grant from Shire Pharmaceuticals. C.P. Kovesdy reports having consultancy agreements with Abbott, Akebia, Ardelyx, AstraZeneca, Bayer, Boehringer Ingelheim, Cara Therapeutics, CSL Behring, GlaxoSmithKline, Rockwell, and Vifor; receiving honoraria from Abbott, Akebia, AstraZeneca, Bayer, Cara, CSL Behring, Rockwell, and Vifor; serving on the editorial boards of American Journal of Kidney Disease, International Urology Nephrology, Kidney International Reports, Kidney Medicine, and Nephrology Dialysis Transplantation; receiving research funding from AstraZeneca, Bayer, Gil-ead, and GlaxoSmithKline; serving as an associate editor of CJASN and Nephron; being employed by Memphis Veterans Affairs Medical Center, University of Tennessee Health Science Center; and receiving royalties from Springer and UpToDate. M. Kuhlmann reports receiving honoraria from Amgen, Bayer Pharma AG, Berlin Chemie, Fresenius, Hexal, ICU Medical, and Medice; serving on a speakers bureau for Fresenius Medical Care; having consultancy Funding Information: agreements with ICU Medical; and being employed by Vivantes Klinikum im Friedrichshain. A. Levin reports having other interests/relationships with the steering committee of the ALIGN trial, the Canadian Society of Nephrology, CREDENCE National Coordinator from Janssen (directed to her academic team), ISN, Kidney Foundation of Canada, NIDDK CURE Chair Steering Committee, and DSMB chair of the RESOLVE trial (Australian Clinical Trial Network); receiving honoraria from AstraZeneca, Bayer, Fresenius, Janssen, and NIH; receiving research funding from AstraZeneca, Boehringer Ingelheim, Canadian Institute of Health Research, and Kidney Foundation of Canada; serving as a scientific advisor or member of AstraZeneca, Boehringer Ingelheim, Chinook Therapeutics, GlaxoSmithKline, Reata, and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); having consultancy agreements with Bayer, Chinook Therapeutics, NIH, and Reata; being employed by BC Provincial Renal Agency, Providence Health Care, and University of British Columbia; and serving on the DSMB for ISN Research Committee, Kidney Precision Medicine, Kidney Scientist Education Research National Training Program, NIDDK, and University of Washington Kidney Research Institute Scientific Advisory Committee. M. Lunney reports being employed by Alberta Health Services and University of Calgary. D. Mafra reports being employed by Federal University Fluminense and serving as a scientific advisor or member of International Urology and Nephrology and Nephrology Dialysis Transplantation. L.W. Moore reports receiving honoraria from, serving as a scientific advisor or member of, and having other interests/relationships with the NKF. I.G. Okpechi reports receiving honoraria from Astra-Zeneca (South Africa) and Fresenius Medical Company. S.R. Price reports serving as a scientific advisor or member of American Journal of Physiology-Cell Physiology, Journal of Renal Nutrition, and Physiological Reviews, and as president-elect of ISRNM. A. Steiber reports being employed by the Academy of Nutrition and Dietetics; receiving research funding from the Academy of Nutrition and Dietetics Foundation, Anjinomoto, Commission on Dietetic Registration, Gates Foundation, National Institute of Child Health and Human Development, and NIH; serving as a scientific advisor or member of the American Council on Exercise scientific advisory panel and of the Journal of Renal Nutrition editorial board; and having ownership interest in Nephroceuticals. A.Y.-M. Wang reports serving as a scientific advisor of member of editorial boards for American Journal of Nephrology, Biomedicine Hub, Blood Purification, CJASN, EMJ Nephrology, JASN, Journal of Diabetes, Journal of Geriatric Cardiology, Journal of Nephrology, Journal of Renal Nutrition, Kidney International, Nephrology Dialysis Transplantation, and Nephron Clinical Practice (associate editor); serving as committee member of International Society of Nephrology (ISN)-Advancing Clinical Trials (ACT), deputy chair of ISN North and East Asia Regional Board, deputy chair of the ISN Education Working Group, council member of International Society of Peritoneal Dialysis (ISPD), president of the International Society of Renal Nutrition and Metabolism (ISRNM), and executive committee member of SONG Initiatives; and having other interests/relationships as committee member of ISN-ACT, deputy chair of ISN Education Working Group, deputy chair of ISN regional board, council member of ISPD, president of the ISRNM, member of SONG-HD CVD Outcome Measures Working Group, executive committee member of SONG Initiatives, and member of SONG-PD Working Group. C. Wanner reports receiving honoraria for steering committee and advisory board membership, lecturing, and travels from Akebia, AstraZeneca, Bayer, Boehringer Ingelheim, Fresenius Medical Care, Gilead, Glax-oSmithKline, Lilly, Sanofi-Genzyme, and Vifor; having consultancy agreements with Akebia, Bayer, Boehringer Ingelheim, Gilead, GlaxoSmithKline, MSD, Sanofi-Genzyme, Triceda, and Vifor; receiving honoraria from Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, FMC, Eli Lilly, Sanofi-Genzyme, and Shire-Takeda; having other interests/relationships with European Renal Association–European Dialysis and Transplant Association; and receiving research funding from Idorsia (grant to institution) and Sanofi-Genyzme (grant to institution). All remaining authors have nothing to disclose. Funding Information: The GKHA project was supported by the ISN (grant RES0033080 to the University of Alberta). The ISN provided administrative support for the design and implementation of the study and data collection activities. The Global Kidney Nutrition Care Atlas was supported by the ISRNM. Funding Information: The GKHA project was supported by the University of Alberta (via the ISN) grant RES0033080. The ISN provided administrative support for the design and implementation of the study and data collection activities. The Global Kidney Nutrition Care Atlas was supported by the ISRNM using a Fresenius Kabi educational grant to ISRNM. Publisher Copyright: © 2022 by the American Society of Nephrology.
PY - 2022/1
Y1 - 2022/1
N2 - Background and objectives Nutrition intervention is an essential component of kidney disease management. This study aimed to understand current global availability and capacity of kidney nutrition care services, interdisciplinary communication, and availability of oral nutrition supplements. Design, setting, participants, & measurements The International Society of Renal Nutrition and Metabolism (ISRNM), working in partnership with the International Society of Nephrology (ISN) Global Kidney Health Atlas Committee, developed this Global Kidney Nutrition Care Atlas. An electronic survey was administered among key kidney care stakeholders through 182 ISN-affiliated countries between July and September 2018. Results Overall, 160 of 182 countries (88%) responded, of which 155 countries (97%) answered the survey items related to kidney nutrition care. Only 48% of the 155 countries have dietitians/renal dietitians to provide this specialized service. Dietary counseling, provided by a person trained in nutrition, was generally not available in 65% of low-/lower middle–income countries and “never” available in 23% of low-income countries. Forty-one percent of the countries did not provide formal assessment of nutrition status for kidney nutrition care. The availability of oral nutrition supplements varied globally and, mostly, were not freely available in low-/lower middle–income countries for both inpatient and outpatient settings. Dietitians and nephrologists only communicated “sometimes” on kidney nutrition care in $60% of countries globally. Conclusions This survey reveals significant gaps in global kidney nutrition care service capacity, availability, cost coverage, and deficiencies in interdisciplinary communication on kidney nutrition care delivery, especially in lower-income countries.
AB - Background and objectives Nutrition intervention is an essential component of kidney disease management. This study aimed to understand current global availability and capacity of kidney nutrition care services, interdisciplinary communication, and availability of oral nutrition supplements. Design, setting, participants, & measurements The International Society of Renal Nutrition and Metabolism (ISRNM), working in partnership with the International Society of Nephrology (ISN) Global Kidney Health Atlas Committee, developed this Global Kidney Nutrition Care Atlas. An electronic survey was administered among key kidney care stakeholders through 182 ISN-affiliated countries between July and September 2018. Results Overall, 160 of 182 countries (88%) responded, of which 155 countries (97%) answered the survey items related to kidney nutrition care. Only 48% of the 155 countries have dietitians/renal dietitians to provide this specialized service. Dietary counseling, provided by a person trained in nutrition, was generally not available in 65% of low-/lower middle–income countries and “never” available in 23% of low-income countries. Forty-one percent of the countries did not provide formal assessment of nutrition status for kidney nutrition care. The availability of oral nutrition supplements varied globally and, mostly, were not freely available in low-/lower middle–income countries for both inpatient and outpatient settings. Dietitians and nephrologists only communicated “sometimes” on kidney nutrition care in $60% of countries globally. Conclusions This survey reveals significant gaps in global kidney nutrition care service capacity, availability, cost coverage, and deficiencies in interdisciplinary communication on kidney nutrition care delivery, especially in lower-income countries.
KW - Cross-Sectional Studies
KW - Dietary Supplements
KW - Global Health
KW - Health Care Surveys
KW - Humans
KW - Kidney Diseases/therapy
KW - Nutrition Therapy
UR - http://www.scopus.com/inward/record.url?scp=85123306068&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85123306068&partnerID=8YFLogxK
U2 - 10.2215/CJN.07800621
DO - 10.2215/CJN.07800621
M3 - Article
C2 - 34980675
AN - SCOPUS:85123306068
SN - 1555-9041
VL - 17
SP - 38
EP - 52
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 1
ER -