Registered dietitian nutritionists are included as collaborators in the newly proposed Increasing Access to Organ Transplants (IOTA) Model, but the Academy is advocating for more integration of nutrition care. In recent comments to the Centers for Medicare & Medicaid Services (CMS), the Academy urged the agency to explore ways to integrate nutrition care metrics more effectively into the proposed model.
The Academy’s recommendations, developed in partnership with the Renal Dietitians and Clinical Nutrition Management dietetic practice groups, focused on developing metrics that ensure access to medical nutrition therapy (MNT) and support patient adherence to dietary and supplement guidance provided by RDNs. While there are quality metrics focused on the importance of medication adherence, research shows that individuals who are post-transplant may have challenges adhering to dietary recommendations, which can potentially lead to complications or impact health outcomes. Nutrition-focused metrics that measure and address the comprehensive needs of kidney transplant patients are crucial to enhancing the quality of care.
Recognizing that pre-transplant nutrition status significantly influences post-operative success, the Academy also advocated for the inclusion of measures to identify those at risk for or who meet the criteria for malnutrition. “Malnutrition is associated with a higher risk of adverse outcomes such as infections, pressure ulcers and reduced wound healing, necessitating additional hospitalizations and medical interventions. Studies have shown that approximately 1 in 5 kidney transplant recipients develop malnutrition, with the risk being even higher at 1 in 3 due to dietary shifts post-transplant,” the submitted comments noted.
The Academy identified barriers to care including obesity and the importance of MNT in helping individuals become eligible for organ transplants. Finally, it was recommended that the Kidney Disease Quality of Life (KDQOL-36) instrument be used to assess nutrition-related impacts on quality of life.
The recommendations to CMS underscore the Academy's commitment to elevating the role of RDNs, improving patient outcomes and ensuring their expertise is recognized and valued as part of interprofessional care models.
Read the Academy’s full comments.
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