Barriers to Plant-Based Diets in Patients with CKD

Background: Multiple studies have linked a highly plant-based diet (PBD) with reduced kidney disease and improved health outcomes in patients with kidney disease. Identifying patient perspectives on the adoption of PBD and potential barriers to adoption will be crucial in increasing uptake. Methods: After ethics approval from the Loma Linda University Institutional Review Board, an anonymized survey accessed via QR code and administered via Qualtrix® was distributed in a multi-ethnic Federally Qualified Health Center in San Bernardino County, California, USA. Respondents were asked general questions about demographics, familiarity with their current kidney disease status, interest in PBDs, and perceived barriers to adopting PBD for their kidney disease care. Proportions and counts are provided for responses. Results: Of the 75 survey participants, 69 answered the questions. The participants consisted of 29 males and 36 females, with the majority being White or Caucasian. The majority of those aware of their kidney disease stage were in stage 3 (estimated glomerular filtration rate [eGFR] 30-59 mL/min/1.73 m^2), and only six were on hemodialysis. The participants were given 12 possible barriers (figure), and the results showed that the most likely barriers were: cost, motivation to eat PBD, receiving adequate calories and nutrients with fruits and vegetables, and support from people in their life for eating a healthy diet. Conclusion: Patients with kidney disease demonstrate a keen interest in PBD as part of their kidney care. Costs and support around maintaining nutrition with PBD are important barriers that patients will need help with to increase the adoption of PBD. Larger studies are required to understand broad issues around PBD adoption for kidney disease.