Dolph Chianchiano

Usefulness of Nutrition Facts Label for Persons With Chronic Kidney Disease

OBJECTIVE We sought to determine what information should be included on the nutrition facts label (NFL) to improve its usefulness for individuals with chronic kidney disease (CKD). DESIGN Our survey asked for frequency of food-label reading, use of information on the label related to specific nutrients, and perceived needs. SETTING Our survey was internet-based. SUBJECTS Our subjects included 317 individuals with CKD and caregivers who self-subscribed to electronic mailing lists maintained by nationally based groups providing education and/or support for individuals with CKD. INTERVENTION The intervention consisted of an analysis of survey results. MAIN OUTCOME MEASURES Main outcome measures included respondent self-reported behaviors, opinions, attitudes, knowledge, and perceived needs related to the NFL in terms of foods and beverages. RESULTS Survey respondents (81.8%) rated nutrition as important (39.2%) or very important (42.6%) when making food choices. A roughly equal number (82.6%) indicated reading the NFL often for the amounts of nutrients in a food. However, less than one fourth of the respondents (24.0%) were able to determine the amount of calcium in a food correctly, based on percent daily value (%DV), and many (64.6%) indicated they did not know how to convert the %DV to an absolute amount (the 100% daily value for calcium is 1000 mg). Respondents indicated that they decided not to purchase foods that did not list absolute amounts of nutrients of concern (58.4% for potassium, and 53.9% for phosphorus) on the NFL. CONCLUSIONS Individuals with CKD would prefer, or find it more useful, to see nutrients of concern listed in absolute amounts on the NFL. They also indicated that potassium and phosphorus should be required on the label, to allow the option of determining whether to include a food in their diet.

Stimulating Patient Engagement in Medical Device Development in Kidney Disease: A Report of a Kidney Health Initiative Workshop

New technologies challenge current dialysis treatment paradigms as devices become smaller, more portable, and increasingly used outside the dialysis clinic. It is unclear how patients will view this care transition, and it will be important to consider patient and care partner perspectives during all aspects of development for novel dialysis therapies, from design and clinical trials to regulatory approval. To gain insight into this area, the Kidney Health Initiative, a public-private partnership between the American Society of Nephrology, the US Food and Drug Administration, and nearly 80 member organizations and companies dedicated to enhancing patient safety and fostering innovation in kidney disease, convened a workshop of patients, care partners, and other kidney community stakeholders. The workshop included background presentations followed by focused small group discussions in 3 areas (device design, clinical trials, and regulatory approval). Participants explored how to involve patients throughout the life cycle of a medical device, including discussions of how patients can influence device design, assist in the planning and implementation of clinical trials, and provide input to affect regulatory decisions. Patients were engaged in the workshop discussion and interested in sharing their perspectives, but they recommended additional efforts around education, communication, and outreach in these areas.

State Approaches to Stem Toll of Chronic Kidney Disease

Two dozen states have undertaken initiatives to address chronic kidney disease (CKD), with the goal of facilitating early identification of CKD and intervention to prevent the progression of CKD and its comorbidities. Each state has approached this goal in a different fashion. The impact of these varying initiatives should be evaluated so as to guide policy development in other jurisdictions.