This course is broken up into (4) 2-hour classes and is under review by CDR for 8 CPE credits

2020 Course Schedule

Class Dates:

  • Wednesday, June 24th, from 1-3pm EST
  • Thursday, June 25th, from 1-3pm EST
  • Tuesday, June 30th, from 1-3pm EST
  • Wednesday, July 1st, from 1-3pm EST

                   (We promise we'll have some breaks)

**All classes will be recorded if you are unable to attend for the live event**

Course Description

  • 1

    Welcome to being a renal dietitian!

    • A special welcome from Jess

    • How to print the slides

    • How to attend the LIVE classes

    • Class Dates: **All classes will be recorded if you are unable to attend for the live event**

  • 2

    Intro to ESRD and HD

    • CLASS RECORDING 1.1 Intro, objectives, basic info

    • CLASS RECORDING 1.2 Etiology, what hemo does, how hemo works

    • CLASS RECORDING 1.3 Access and Adequacy

    • CLASS RECORDING 1.4 Modern versus Liberalized Renal Diet

    • Class Slides- Module 1

    • Labs to know reference sheet

    • Traditional Renal Diet vs Modern Renal Diet

    • Test your Understanding

    • Feedback for us please!

  • 3

    Albumin and Inflammation

    • Module 2: Part 1

    • Module 2: Part 2

    • Module 2: Part 3 Case Studies

    • Class Slides- Module 2

    • Albumin decision tree.docx

    • Albumin as a Nutritional Marker in Kidney Disease

    • Inflammation Cheat Sheet

    • Test your understanding

    • Feedback for us, please:)

  • 4

    Protein and Malnutrition

    • Module 3 Recording: Part 1

    • Class Slides- Module 3

    • Malnutrition Screening Tool

    • SGA Tool

    • Malnutrition inflammation index form

    • Protein food sources

    • Protein powerhouse handout

    • Adding more calories & protein handout

    • Test your learning

    • Feedback for us please:)

  • 5

    Potassium

    • Class Recording Day #3 (includes multiple topics - will be pieced out ASAP)

    • Class Slides Module 5

    • REL_Double-Boil-Your-Potatoes (2)

    • Test your understanding

    • Possible Non-Diet Hyperkalemia

    • Feedback for us please:)

    • Potassium case studies

  • 6

    Bone Mineral Disease Management

    • Class Recording

    • Class Slides- Module 4

    • Test your learning

    • Blank VDRA Dosing Spreadsheet + Instructions

    • Phos Binders Dosing and Considerations

    • Excellent Secondary Hyperparathyroidism Overview

    • Hidden Phos 1

    • Hidden Phos 2

    • Article Understanding Sources of Dietary Phosphorus in the Treatment of Patients with CKD

    • Update on Phos Binders

    • THE-MAGIC-OF-YOUR-PHOSPHATE-BINDERS-HANDOUT

    • Phosphorus case studies

    • PTH Case studies

    • Resources

    • Phosphorus IQ Quiz

    • Binder decision tree

  • 7

    Sodium and Fluid

    • Live Class Recording

    • Class recording

    • Class slides- Module 6

    • IDWG Excel Tracking Sheet

    • Test your understanding

    • Sodium Strategies Handout

    • Sodium Strategies Handout 2

    • Sodium and fluid counseling article

    • Why-does-fluid-matter_

    • 10-Tips-to-Stay-Cool-and-Avoid-the-Summer-Fluid-Gains

    • Dry Mouth Handout

  • 8

    Must-read articles

    • Copy of modified nutrition recommendations for ESRD

    • Copy of Evidence for renal diet Vol36_No4_2017_FEATURE

    • Keryx-white-paper-091012

    • Hidden phos and K+

    • Renal Nutr Forum General Info on Spec Topics aka Herbs, portions, meal plans

    • The Gut Microbiome, Kidney Disease, and Targeted Interventions

    • What RD's Need to know about Gut Microbiome

  • 9

    Our best tips for making your daily life a whole lot easier!

    • How to use this tool: Monthly lab reports- sample

    • The LITTLE things that make a BIG difference in your outcomes

    • Clinic engagement strategies that fit you

    • Using PES statements and nutrition diagnosis

    • Monthly time management - LIVE discussion July1

    • Setting Boundaries + Staff Relationships that make work much much better

    • QAI/CQI tips for success

    • Use your strengths, strengthen your weaknesses

Renal nutrition is a whole new world...


The renal world is full of new acronyms and abbreviations, labs and patients that don’t follow the usual rules, new medications that you are responsible for managing, juggling multiple disease states, and a diet that seems to fly in the face of decades of healthy eating research.  It can be overwhelming, confusing, and frustrating. On top of that, you quickly find out that everyone - doctors, nurses, patients-  is looking to you to be an expert from day 1 on all things renal. It’s definitely a humbling first couple years as you realize you have a lot to learn.  

However, it can also be rewarding by pushing you to be more creative and raising your clinical judgment and knowledge to new heights.  You also have the unique opportunity to work with a team that can give you great support and together you see lives change and improve.   This is the renal world.  

So consider this course as your cultural and travel guide to help you learn the new language and culture, be confident in finding your way around- and help others find their way as well, and experience all the great attractions to make your renal world adventure unforgettable- in a good way.

Course Objectives

•Understand kidney disease, treatment, nutritional guidelines and needs of individuals receiving hemodialysis (HD)

•Confidently analyze and assess labs, symptoms, diets, medications and physical assessment of individuals receiving HD

•Identify nutrition needs and work with the patient to implement evidence-based nutrition interventions

•Evaluate and monitor effectiveness of interventions, and make appropriate changes if needed

The objectives are covered in each of these 6 modules:

1- Overview of kidney disease, dialysis, the renal dietitian’s role, and the renal diet: 

  • Functions of the kidney, causes of kidney disease

  • How dialysis works, dialysis access and how dialysis and access type  impacts labs

  • Review of labs- what makes them high or low, renal ranges

  • Renal dietitian role and responsibilities (labs, nutrition assessment on a monthly basis, patient nutrition needs )

  • Renal diet- components of traditional and liberalized renal diet, the evidence supporting implementing each 

2- Inflammation and Albumin:

  • Inflammation in CKD- causes and contributions

  • Assessing inflammation in patients (conditions, lifestyle, diet symptoms, labs)

  • Albumin role and importance in dialysis patients

  • KDOQI guidelines and recommendations for albumin

  • Interventions for inflammation and low albumin

  • Case studies

3- Malnutrition and protein

  • Complexities of malnutrition in CKD

  • Protein needs and how to assess protein intake

  • Protein food sources

  • Diagnosing/ screening for malnutrition: SGA, malnutrition inflammation score, malnutrition screening tool

  • Causes and intervention for malnutrition and decreased intake

  • Using protein supplements: KDOQI and evidence based guidelines

  • Case studies

4- Bone and mineral management (Access to just this session

  • Review relationship between PTH, calcium, phosphorus and vitamin D

  • Bone and mineral diseases and how they impact calcium, PTH and phosphorus

  • Target ranges for bone and mineral labs

  • How medications impact bone and mineral labs

  • Overview of medications used in bone and mineral management- how they work, starting doses, considerations

  • For phosphorus, PTH, calcium and vitamin D- impact on CKD outcomes, causes of abnormal levels, dietary impact, evidence-based guidelines for target ranges, assessment and interventions, clinical tools for using different medications, sample protocols for monitoring and evaluation.

  • Case studies

5- Potassium balance

  • Impact of potassium in CKD

  • Guidelines and evidence for target ranges, causes and interventions

  • Non-dietary causes for high potassium

  • Food sources for potassium

  • Medications to lower potassium

  • Monitoring and evaluation

  • Case studies

6- Fluid and sodium management

  • Impact of sodium and fluid on CKD

  • Guidelines and evidence for target ranges, causes and interventions

  • Review ultrafiltration impact on outcomes in CKD

  • Fluid issue root causes and tailored approaches for each cause
    • Fluid restriction- what counts as a fluid, strategies for monitoring fluid
    • Sodium restriction- primary sources of sodium, strategies for reducing sodium intake

    • Dry mouth- causes and interventions

    • Psychological and psychosocial causes and interventions

  • Tools for monitoring and evaluation of fluid gains and sodium intake

  • Case studies


PLUS: 

- References for more in-depth study

- Curated patient handouts and clinical resources for each module 

- Guidance on resources for further training in renal nutrition, kidney disease and counseling techniques,  CEUs, and patient handouts

Your Instructor

Lindsey Zirker, MS, RD, CSR, LD


I am beyond excited to introduce Lindsey Zirker  as the instructor for the MNT in Hemodialysis Course. I met Lindsey at National Kidney Foundation Spring Clinicals over ten years ago as a newbie dietitian and was immediately drawn to her in depth but practical knowledge regarding implementing the best science-based nutrition guidelines. As a new dietitian more than ten years ago, she answered many many many of my questions as I became oriented to working in dialysis 

Lindsey has been in the nephrology field in some capacity her entire career. She spent more than 10 years as the dietitian at the Idaho Kidney Center.  She now serves as the Program Development Director for the RenAlign non-profit and spends the majority of her time creating incredible evidence-based resources and courses to help renal dietitians. She runs a private practice on the side seeing people with early stage CKD.


She has an incredible capacity for taking a deep dive into the science of nutrition and assimilating it into practical practice. She is an accomplished speaker that can take complex science on topics such as inflammation or gut health, and make them simple and applicable in daily practice.