WRNMMC, Bethesda, MD  –   Approximately 37 million people in the United States are estimated to have chronic kidney disease (CKD), and as many as nine in 10 people are not aware of it, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
It is for these reasons, and to raise awareness of CKD, and in hopes of building paths to better kidney care, that National Kidney Month is observed during March alongside National Nutrition Month.
It's for these reasons, and to raise awareness of CKD, hoping to build paths to better kidney care, that National Kidney Month is observed during March, which is also National Nutrition Month.
Walter Reed National Military Medical Center’s Renal Dietitian Wendy Caesar-Gibbs, of the Nutrition Services Department, is focused on building paths to better health not just during March, but each and every day with her patients. She cares for patients who have renal disease, some of whom have undergone a kidney transplant.
Caesar-Gibbs is also a part of the Organ Transplant Team at WRNMMC, providing nutrition assessments and evaluations of potential kidney transplant recipients, those who have received transplants, and donors.
"The main function of the kidneys are the removal of waste products, removal of excess fluid, and to make urine," Caesar-Gibbs explained. "The kidneys balance minerals and salts in the body, such as calcium, phosphorus, potassium, and sodium. The kidneys help to regulate blood pressure, red blood cell production and maintain healthy bones. Eating an excessive amount of sodium and an excessive amount of protein can place additional stress on the kidneys."
She said kidney disease can develop from hypertension and diabetes, which may have resulted from poor lifestyle habits. "These lifestyle habits include excessive caloric intake, sodium intake from processed foods, and lack of physical activity, which can lead to obesity, diabetes, and hypertension.”
"As a renal dietitian, I am responsible for assessing the nutritional status of our clients with all aspects of kidney disease, including CKD, dialysis, and kidney transplant recipients, and providing nutrition education and counseling regarding the renal diet. I also counsel patients regarding diabetes, hypertension, kidney stones, and weight management, since these issues can also impact kidney function," Caesar-Gibbs furthered.
"Lifestyle modifications are part of initial treatment interventions for prediabetes, diabetes, hypertension, and cardiovascular disease, which can help improve kidney function. A low sodium, low fat, high fiber, and low carbohydrate diet can improve prediabetes, diabetes, cardiovascular disease and hypertension, which may slow down the development or progression of kidney disease,” Caesar-Gibbs explained.

Caesar-Gibbs said she counsels her patients that developing a lifestyle to avoid hypertension and diabetes, you can also help reduce the probability of developing kidney disease. "I counsel them to consume a high fiber, low sodium, moderate protein diet. I also counsel them on the importance of regular physical activity and keeping well hydrated."
This advice is in line with recommendations from the NIDDK, which states to build a path to better kidney care, people should:
* Be active participants in their care, working with their health-care team to create a treatment plan that fits their lifestyles, mobility, health status, and dietary needs.
* Follow care plans. Take medicine as prescribed and stay up to date on vaccines. The COVID-19 and flu vaccines are especially important for people with kidney disease, who may be more likely to get very sick from COVID-19 or the flu.
* Build a kidney healthy lifestyle. Try to incorporate healthy habits into your daily schedule. This should include healthy foods and beverages, physical activity like walking or taking the stairs to help you stay active and manage weight, and a sleep routine that helps you get enough rest.
Regarding her patients who have undergone a kidney transplant, Caesar-Gibbs said good nutrition helps with the healing process after the procedure.
"If an individual has been on hemodialysis prior to receiving a kidney transplant, they may now be able to consume items that were once restricted," she explained.
"The most rewarding part of my job is seeing my patients’ lab and health status improve due to the lifestyle changes they have made," Caesar-Gibbs said. Conversely, she said the most challenging part of her job is when patients do not adhere to their dietary restrictions, which results in abnormal labs and declines in nutritional and medical status.
"I would like for people to understand that small changes in their lifestyle can result in a large improvement in their health status, and it's never too late to make a change in behavior," Caesar-Gibbs concluded.