Desiree de Waal

Desiree de Waal

University of Vermont Medical Center, USA

Title: Medical Nutrition therapy delays dialysis and improves biomarkers


Desiree joined the Nephrology Team at the University of Vermont Medical Center in 2002. She is a member of the dialysis team and started the Medical Nutrition Therapy Clinic in 2003. She has coordinated multiple investigational trials and recently completed her own research on Medical Nutrition Therapy improving CKD outcomes. Desiree was awarded the Dietitian of the Year Award in Vermont (2013) and Fellow of the Academy of Nutrition and Dietetics (2014). She participates in Evidence Analysis Projects and a member of the Evidenced- Based Practice Committee. She is the Editor of the Peer Reviewed Newsletter “Renal Nutrition Forum”.


As kidney disease progresses, altered nutrition biomarkers are observed which may be related to poor dietary habits. The typical North American diet is low in fruits, vegetables and whole grains high in protein and processed foods which can affect the balance of the body’s electrolytes, minerals and contributes to the uremic environment of the digestive system. Evolving evidence has found a link between the gut and kidney health suggesting a need for emphasis on nutrition for the care of a patient with compromised kidney function. Recently a 10 year retrospective study was recently published in the Journal of Renal Nutrition demonstrating that the decline in kidney function was less in patients who received Medical Nutrition Therapy (MNT) at follow-up compared to those not receiving MNT. The participants who received MNT were less likely to start dialysis and had more favorable biomarkers. Albumin and biomarkers of chronic kidney disease- mineral and bone disorder were more likely to be within normal limits in the MNT group. The kidney diet is one of the most challenging obstacles patients face. Diet is often entrenched as part of a person’s lifestyle and they do not feel an immediate negative physical response with poor diet choices. With costs of kidney disease rising, it seems prudent to recommend a therapy that has been shown to delay the progression of kidney disease and improve biomarkers.