A Center for Nutrition Care to Provide Renal Nutrition Therapy to Chronic Kidney Disease Patients.

Objective: This paper describes a novel program that provides nutritional care to people with chronic kidney disease (CKD).

Design and methods: This is an observational study of the structure and function of Centro de Atencion Nutricional-Center of Nutritional Care (CEAN) Centers in metropolitan areas in Mexico that provide nutritional care to patients with CKD. Data on nutritional outcomes to treatment were obtained retrospectively from clinic records.

Results: The centers consist of several offices that are staffed by licensed dietitians who have undergone training in renal nutrition and are experienced in treating CKD patients. Any licensed physician in Mexico can refer patients to these centers for nutritional assessment and counseling. At their initial visit, patients undergo a comprehensive nutritional assessment by a dietitian, which includes anthropometry, bioelectrical impedance and handgrip strength, and requests for laboratory measurements. A nutritional diagnosis and dietary treatment plan are developed. The patient's referring physician receives a typed consultation. Almost 50% of the patients make 4 or more follow-up visits to the Center. Those patients who had an initial visit and a tenth visit displayed a reduced dietary protein intake with no reduction in serum albumin or handgrip strength. Body mass index, which averaged overweight, decreased slightly.

Conclusions: Centro de Atencion Nutricional in Mexico can provide sophisticated nutritional assessment, dietary therapy and nutritional follow-up for patients with CKD. Preliminary data suggest good nutritional responses in these centers. Clinical trials are needed to examine more definitively whether these centers improve nutritional and clinical outcomes in patients with CKD.