Navigating Nutritional Challenges and Applying Implementation Science and Practice in Kidney Diseases and Transplantation

Abstract

The association between diet and kidney function has long been studied. Cumulative evidence has shown the benefits of dietary modification, particularly low dietary protein and sodium intake and the higher proportion of plant vs. animal protein. However, the practicality of implementing dietary intervention faces challenges due to several determinants from a wide range of influences, including biological factors, behavioral factors, the physical or built environment, the sociocultural environment, the policy or political environment, and the healthcare system. Additionally, the implementation of nutritional and dietary interventions depends heavily on health-related behavioral factors. To achieve effectiveness in implementing dietary interventions, theories, frameworks, and models relevant to health-related behavioral changes should be incorporated. This will allow providers to better understand the rationale of dietary interventions. An accurate assessment of diet implementation success vs. failure can enhance implementation strategies and extend diet practice not only for favorable clinical and service outcomes in kidney care and renal transplantation but also for implementation outcome measures and better-aligned research in the diet and nutrition field.