Learning the Ropes of Renal

Danielle Ferguson

Honestly, ever since my Anatomy 2 class where I learned about kidneys and the role they play in the body, I’ve been obsessed. If it’s possible to have a favorite organ, the kidneys may be mine. From the way they regulate blood pressure, to filtering the blood, to secreting different hormones, I find them fascinating. I have always been curious what it would be like to be a renal dietitian so I am thrilled to have the opportunity to explore the role of a dietitian in a dialysis center during this internship. 

Dietitians play many roles in a dialysis center, including exploring the clinical aspects of patients care, counseling, providing nutrition education on the renal diet, and aiding in the management of medications, vitamins and minerals. One of the aspects I love in this focus of nutrition is the relationships that you are able to buildwith the patients. The dietitians I worked with at Fresenius manage about 120 patients, sometimes at 2 different clinics. This is a large caseload. Due to the nature of dialysis, however, they work with these patients throughout an extended amount of time. They have the ability to build rapport and mutual respect. Beginning dialysis can be a very overwhelming time for patients, and the dietitian can help make this time a bit more manageable with the education and information they provide.

During my rotation, I was able to provide nutrition education to patients. Some of the most important counselling I provided was explaining the different types of foods patients can have and those they should avoid. The two nutrients that are often necessary to limit in the renal diet are potassium and phosphorus. Potassium is found in foods such as bananas, potatoes, beans, and tomatoes, while phosphorus is found in foods such as dairy products, dark cola, chocolate, processed and packaged foods, and beer. Although there is an extensive list of foods these patients are advised to avoid, the dietitians I worked with chose to guide the patients towards the foods they can have. Emphasizing adequate protein intake is important with this disease state. Patients on a pre-dialysis renal diet often must restrict protein intake because it overworks the kidneys to have to remove protein waste products from the blood. However, once dialysis begins, this protein restriction is lessened since when the dialysis machine filters wastes from your blood, it can also remove protein. During this rotation, I learned the nuances of factoring in a patient’s disease, type of treatment, and nutritional status to determine an appropriate goal for protein intake.

Learning how to nutritionally manage a disease as complex as kidney disease is an exciting challenge that I will continue to practice throughout my career. In this blog post, I have only presented a snapshot of my experience working with these amazing and passionate dietitians who put their hearts into their work. Seeing the importance of a renal dietitian in a dialysis setting has me excited about yet another potential career path. There are so many ways to make an impact on the lives of others, and having explored the crucial role of a dietitian, I know I have chosen the right career for me to help others.