#RenalDietChallenge: How Much Phosphorus Is In This Meal?

In May 2017, a group of eight nephrology healthcare workers participated in the renal diet challenge where, for three days, they followed the diet that is recommended to patients diagnosed with end stage renal disease (ESRD).

Timothy Yau (AJKDBlog)AJKD’s Social Media Editor, interviews two of the participants about their experience. Beth Durkee (BD) is a nephrology social worker and Terry Mehigan (TM) is a nephrology nurse practitioner.

Images included with permission from Katie Kwon (@KatieKwonMD); more images and updates can be found via #renaldietchallenge.

AJKDBlog: First, congrats on bringing attention to challenges of the renal diet. It was really engaging to see the pictures and comments on Twitter. Can you tell us about each of the participants, and how you came up with the idea?

BD: Terry Mehigan, the nurse practitioner, came up with the idea to assist staff to understand a piece of the challenge our patients with ESRD are charged with undertaking. The diet is part of the larger picture of what they face, including dialysis, fluid restriction, and medications, along with other complications.  Following the diet for three days gave us some insights into our patient’s daily lives.

Other participants included our medical director, dietitian, a patient care tech, and myself, the social worker.

AJKDBlog: When you started the challenge, what kind of educational materials did you give to the participants? Was the paperwork overwhelming, and was it harsh to realize your food limitations?

BD and TM:  Our dietitian, Marlena, gave us the same materials that she gives to the patients. The materials listed foods to choose and foods to avoid but did not tell us how much was allowed. We had to limit our intake of potassium and phosphorus while increasing our intake of protein. It was a wake-up call to realize how difficult the diet was.

AJKDBlog: The renal diet includes limitations on many different things (sodium, phosphorus, potassium). What was the hardest thing to restrict during the 3-day challenge for each of you?

BD: I had a hard time with the potassium. I LOVE fresh tomatoes and tomato sauces.

TM: By far the hardest challenge was phosphorus. You just literally have to learn what is high in phosphorus because it is not on any food label that I could find.

AJKDBlog: One of the images I noticed was that when a meal was provided by the hospital, there were very limited options for those adhering to a renal diet. It must have been really difficult to skip these meals and go hungry.

AJKDBlog: What was your favorite meal during the challenge?

TM: I guess I would say grilled chicken with fresh veggies. I have to laugh about this because during the 3 days I had chicken and fresh veggies every night.

AJKDBlog: Do you remember what was the first meal you ate after the challenge?

BD: Grilled chicken with a tomato salsa!!

TM: I went to my favorite Italian restaurant and had green peppers and sausage mostaccioli.

AJKDBlog: After going through the #renaldietchallenge, how do you think we can improve nutrition education for our patients?

TM and BD: Give recipes and amounts of potassium and phosphorus in the recommended foods. We talk so much about a low phosphorus diet, yet there is very poor labelling for phosphorus on most foods.


AJKDBlog: Our thanks to Terry Mehigan and Beth Durkee for taking the time to do this interview, and thanks to Katie Kwon for sharing the photos of her diet during the #renaldietchallenge. And thanks again to all of them for bringing attention to the challenges of a renal diet!


2 Comments on #RenalDietChallenge: How Much Phosphorus Is In This Meal?

  1. Denise Eilers, BSN, RN // October 9, 2017 at 4:14 pm // Reply

    The Renal Diet Challenge is a valuable and interesting exercise, but for those on more frequent/nocturnal hemodialysis, there are few, if any, dietary restrictions. Although thrice weekly in center dialysis is the norm, with timely and proper pre ESRD referrals and education about all modalities, many more patients could go home. A survey from a couple of years ago asked nephrologists what modality they would choose if transplant wasn’t an option. Almost 90% said “home.”

  2. Nyaundi Mathew // October 24, 2017 at 5:01 am // Reply

    It real challenges us as patients more so when you get one is allowed to use what his colleague is restricted to avoid.

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