NUTRITIONAL-SUPPORT-FOR-PATIENTS-WITH-KIDNEY-FAILURE-PROGRAM.PDF

Last updated: 04/03/2018
General information
Organization National Kidney Foundation of Arizona
Contact First name James
Contact Last name Ivie
Contact e-mail jivie@azkidney.org
Contact phone number 602-840-1644
Address
Street 360 E. Coronado Rd., Suite 180
City Phoenix
State Arizona
ZIP Code 85004
From what tribe is the Fort McDowell Yavapai Nation
organization requesting the
grant?
Total grant amount request 40,000
1 / 1


360 E. Coronado Road
Suite 180
Phoenix, AZ 85004
Tel 602.840.1644
Fax 602.840.2360
www.azkidney.org
OFFICERS Ms. Verlene Enos April 3, 2018
Chairman Tribal Secretary
Michael Krassner Fort McDowell Yavapai Nation Tribal Council
Secretary P.O. Box 17779
Victoria A. Bellomo, Esq. Fountain Hills, AZ 85269
ATTN: Prop 202 Grant Application
Treasurer Requesting $40,000
Keith Killough
BOARD OF DIRECTORS Local Government Entity Contact: Organization applying for funding:
Andrew M. Baer
Gina Barletta, MD Maricopa County Board of Supervisors National Kidney Foundation of Arizona
Betsy Bombeck Zachary Wolfe James Ivie, PhD, LCSW
Lynne A. Boschee
Robert S. Cohen, MD Maricopa County Government Relations Director of Patient Services
Randy Cooper, MD 301 W. Jefferson, Suite 960 360 E. Coronado Rd., Suite 180
James Goodnow Phoenix, AZ 85003 Phoenix, AZ 85004
Kenneth Moskow (602) 506-8932 (602) 840-1644
Savas Petrides, MD MC12PercentGamingGrant@mail.maricopa.gov jivie@azkidney.org
Charlie Thomas, LCSW
Daniel F. Walton, MD
MEDICAL ADVISORY BOARD Dear Ms. Enos,
Chairman
Robert S. Cohen, MD
The Nutritional Support for Patients with Kidney Failure Program is a continuing
IN MEMORIAM project that is a joint effort of the National Kidney Foundation of Arizona (NKF AZ), the
Carol G. Bombeck Arizona Council for Renal Nutrition, and Arizona Nephrology Social Workers. The
Erma Bombeck program is designed to identify kidney failure patients who are on dialysis and who are
Melvin L. Cohen, MD
Kenneth E. Johnson, Sr., MD contending with one of the following three conditions: 1) they are new to dialysis and are
Daniel J. Potter, MD failing to thrive, 2) they have been on dialysis for more than three months and are
Glenna Jones Shapiro malnourished as evidenced by abnormal labs and/or weight loss, or 3) their poor oral
health/dentition prevents consumption of the high protein meats and other foods they
CHIEF EXECUTIVE OFFICER need. Patients who exhibit these conditions can apply to NKF AZ for grocery
Jeffrey D. Neff
assistance, a copy of our “Cookbook: A Guide for Renal Nutrition,” protein supplements,
and/or dental care to restore a healthy nutritional status.
The purpose of our Program is to prevent malnutrition, enhance consistency in patient
education, facilitate adherence to diet recommendations, and improve health outcomes.
These goals meet Fort McDowell’s funding priorities in both health and education. Diet
restrictions for dialysis patients limit and regulate the intake of fluid, sodium,
phosphorus, calcium, and potassium while encouraging the use of protein-rich foods.
Many dialysis patients are diabetic and must contend with the requirements of a diabetic
diet as well. Adjustment to the logistical, dietary, financial, and emotional challenges of
dialysis can be daunting and the first three months can be the hardest of all. The needs
that the Program aims to fulfill are threefold:
1) For patients who are new to dialysis and failing to thrive, there is often a need for
more individualized nutritional education and financial assistance. There is a learning
curve for patients over the first few months of dialysis as they adjust to diet restrictions

360 E. Coronado Road
Suite 180
Phoenix, AZ 85004
Tel 602.840.1644
Fax 602.840.2360
www.azkidney.org
and the impact on their grocery budget. Dialysis facility dietitians can apply to NKF AZ for a grocery store gift card
and a cookbook. When an application is approved and a grocery store card is issued, it is the dietitian who receives
it at the dialysis facility. The card is then given to the patient in the context of a nutritional education presentation that
includes a review of what foods conform to the renal diet; what foods need to be avoided; a list of the current week’s
grocery store specials that are rich in protein, low in sodium, low in phosphorus, low in calcium and low in potassium;
and a selection of recipes from the NKF AZ Cookbook: A Guide for Renal Nutrition that makes use of recommended
foods. The patient is then assigned “homework” to use the grocery store card to purchase food items listed in the
recipes and to prepare healthy meals. The patient is instructed to report back to the dietitian on how they completed
the assignment and what they learned. Our Cookbook is a tool for nutritional counseling and meal planning that
reduces the “guess work” involved when advised to control the intake of protein and other nutrients.
2) For patients who have been on dialysis for more than three months and who are malnourished as evidenced by
abnormal labs and/or weight loss, there is a need for protein supplements (liquids, powders, and bars) to prevent
cachexia (severe loss of weight, muscle atrophy, fatigue, weakness, and significant loss of appetite). It is well
established that dialysis patients whose blood laboratory values show low protein levels have significantly higher
rates of mortality. This protein malnutrition is often due to the inability to consume adequate protein because of poor
physical or oral health, social and cultural practices and/or financial barriers. The availability of protein supplements
offers the opportunity to reverse the risk of cachexia nutritionally.
3) For patients with poor oral health/dentition, there is a need for assistance with the cost of cleanings, fillings,
extractions, crowns, and dentures in order to eliminate pain or infections and to restore the ability to chew solid high-
protein foods. The Program can prevent periodontal diseases from contributing to malnutrition or becoming a source
of systemic inflammation for patients with kidney failure.
The Program serves dialysis patients throughout the entire state of Arizona. There are currently over 9,500 dialysis
patients statewide and their numbers continue to grow. Historically, our food assistance, nutritional supplements,
and dental care programs have been used by about 10% of the kidney failure population, which represents hundreds
people. It is projected that over 900 patients could be served by the Program in the coming year.
There are over 120 dialysis facilities in Arizona and all of them can refer patients to the Program. The dialysis
facilities are owned by several different companies, such as Fresenius, DaVita, Southwest Kidney Institute, U. S.
Renal Care, Dialysis Centers Inc., and American Renal Associates. Applications for assistance are received on a
continuous basis through renal dietitians and social workers who identify patients in need. Some funding for the
Program is received from the State of Arizona Department of Health Services, but most of that funding is dedicated
to transportation assistance. An application is being submitted to the Gila River Indian Community but it does not
involve a request for funding for this Program. The timetable for implementation of the Program encompasses the
whole of fiscal year 2019, which spans from July 1, 2018 through June 30, 2019.
PROJECTED PROGRAM BUDGET
Program Category Amount Requested Total Program Budget Projected Numbers of
from Ft. McDowell Patients Helped
Dental Care $20,000 $80,000 200
Protein Supplements $15,000 50,000 550
Food & Cookbook $5,000 10,000 160
Total: $40,000 $140,000 910