"My Patients Cannot Follow The Diet": Malaysia's Kidney Care Community Spent Two Days On That One Question

Subscribe to our FREE Newsletter , or Telegram and WhatsApp channels for the latest stories and updates.

One session at Malaysia’s largest renal nutrition conference held recently carried a title that stood apart from the clinical language around it.

“My patients cannot follow the diet. What can I do?”

That question — the actual name of a forum at the 6th Renal Nutrition Conference 2026 (RNC2026) — framed what the conference spent two days trying to answer.

The conference, held at Grand Dorsett Subang on 10 and 11 October, drew 450 healthcare professionals from across the renal care community, including nephrologists, dietitians, nurses, pharmacists and allied health professionals.

It was organised by the National Kidney Foundation of Malaysia (NKF) under the theme “Translating Nutrition Evidence into Kidney Patient Care.”

The theme, in practice, is a diagnosis of a gap, and the conference placed the Kidney Disease: Improving Global Outcomes (KDIGO) 2024 recommendations — the most current global framework for nutritional management in chronic kidney disease (CKD) — at the centre of that examination.

The discussions did not centre on what the guidelines say.

They centred on whether clinicians are applying them, and whether patients are benefiting when they do.

Five Points of Failure

Dr Izzuna Mudla Mohamed Ghazali, Deputy Director of the Medical Development Division at the Ministry of Health Malaysia (KKM), officiated the opening and placed the conference within the broader direction of the national health system.

The theme of this year’s conference reflects an important principle in healthcare — that knowledge and evidence must ultimately contribute to better care and improved outcomes for the people we serve.

She noted that the conference complements the ministry’s Health White Paper, which sets out a long-term direction for transforming health service delivery, strengthening disease prevention, developing the healthcare workforce, and advancing evidence-based practice.

Translating evidence into care requires people who understand the evidence, the skills to apply it, and healthcare systems that support its implementation.

Dr Izzuna said the conference brings together these important elements.

Dr Thiruventhiran Thilagananthan, Vice Chairman of the NKF Board of Directors, stated the problem directly.

Knowledge is important, but its true value lies in how we translate it into practice and whether it ultimately makes a difference to the patient.

The conference identified five areas where that translation is most at risk: applying updated evidence across CKD stages, managing complex nutritional challenges, improving dietary adherence, integrating digital health tools, and building practical clinical skills.

Dr Izzuna (centre) officiating the launch of RNC2026, joined on stage with Dr Thiruventhiran (right) and Dr Tilakavati Karupaiah, Chairperson of the Renal Nutrition Conference 2026 Scientific Committee. (Pic: NKF)

The Complexity Is Not Theoretical

A patient with CKD may present with obesity while simultaneously losing muscle mass.

Another may appear to maintain an acceptable body weight while experiencing malnutrition or frailty.

Standard dietary formulas do not resolve either scenario.

The programme addressed nutritional challenges including protein-energy wasting, sarcopenia, ultra-processed food consumption, sodium, potassium and fluid management — conditions that do not resolve through a single intervention and do not respond to advice the patient cannot realistically follow.

The forum on dietary adherence brought together a nephrologist, a CKD nurse, a dietitian and a dialysis patient to examine how dietary interventions could be co-designed with patients rather than prescribed to them.

Dr Thiruventhiran added: “The question is not only what the patient should do, but what we can do to help the patient succeed.”

The conference also addressed what happens when clinicians leave the room.

Digital health tools — including mobile applications for dietary monitoring, education and follow-up — were examined for their potential role in extending nutritional support beyond the clinical setting.

At the same time, the programme covered the gut microbiome, physical activity in CKD, and nutritional management during Ramadan and festive seasons, reflecting the practical realities of managing a chronic condition within Malaysian daily life.

Workshops covered phosphate control using real-world food examples and food labels, nutrition screening and assessment, and muscle function assessment.

Measuring What Matters

NKF framed the conference within a broader accountability question.

Dr Thiruventhiran posed three questions he described as fundamental to measuring progress in renal care: whether healthcare professionals are keeping up with the latest evidence, whether they are translating that evidence into practice, and whether patients are benefiting from it.

The ultimate measure of progress is not simply how much we know, but how effectively that knowledge improves the care and quality of life of people living with kidney disease.

Dr Izzuna echoed the same measure from the ministry’s perspective.

Strengthening our healthcare system will require continued investment in people, knowledge, collaboration, innovation and evidence-based practice, she said.

The success of healthcare transformation ultimately depends on how effectively these elements come together in the delivery of care.

The conference concluded with a renewed emphasis on multidisciplinary collaboration — between nephrologists, dietitians, nurses, pharmacists and allied health professionals — as the structural condition for closing the gap between what the evidence recommends and what the patient experiences.

Dr Izzuna described that collaboration as a shared responsibility extending beyond any single organisation.

Strengthening healthcare is not the responsibility of one organisation alone. Platforms such as RNC2026 demonstrate the value of collaboration between organisations and professionals with a shared commitment to improving kidney care.

NKF was established in 1969. It operates subsidised haemodialysis centres and programmes covering prevention, intervention, education, research and advocacy.

Share your thoughts with us via TRP’s Facebook , X , Instagram , or Threads .