COIN Fellows
COIN Fellows
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Luis M. Perez, PhD, RD
- Title: Allied Health Research Fellow
- Contact: luis.perez2@va.gov
- Location: Denver
Research Interests
See Dr. Perez's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
Dr. Luis Perez’s research is focused on nutrition education, counseling, and multiple aspects of medical nutrition therapy in patients with chronic illnesses, such as kidney disease. His current research focuses on understanding the relationship between dietary patterns and intake and clinical or patient centered outcomes in Veterans. He has a combination of both in-patient and out-patient clinical nutrition experience, as well as experience in pilot clinical trials, survey methodology, and intermediate level statistics. In his fellowship, he is learning the Veterans’ healthcare system as well as implementation science, and qualitative and mixed methods study design.
Patients with chronic kidney disease (CKD) patients face one of the most difficult diets among clinical patient populations, especially when combined with diabetes and/or cardiovascular disease. In addition, U.S. veterans have a 34% higher prevalence of CKD than the general population with estimates ranging from 8-36% of the veteran population having CKD. These patients affected by greater health disparities (e.g., appetite problems, food security, etc.) than healthy individuals, which worsens malnutrition and death rates, as well as quality of life.
My research goal is to improve care and further establish the link between diet and health/disease, while developing resources and interventions to improve these factors. I aim to support Veterans and the VA by connecting patients to important resources and evidenced based care while improving healthcare disparities.
Poster presentation for National Kidney Foundation Spring Clinical Meetings 2023 (click the image to enlarge):
The following images visualize Dr. Perez's work. The word cloud is drawn from publication titles. The research collaboration map shows research relationships (click the image to enlarge):
| Publications |
|---|
| Clinical Research |
| Cardiovascular |
| Kidney Disease |
| Prevention |
| Assistive Technology |
| Bioengineering |
| Nutrition |
| Hypertension |
| Clinical Trials and Supportive Activities |
Grants & Funding
Veteran Patient Perspectives and Engagement with Chronic Kidney Disease, Nutrition, and Medical Meals
Over 500,000 Veterans suffer from chronic kidney disease (CKD) at a prevalence 16 to 36% higher than in the general population, with ~30,000 incident cases among Veterans annually. Nearly 40,000 Veterans have end-stage kidney disease treated with dialysis, with ~13,000 new cases yearly. An overwhelming majority of kidney disease is caused by or associated with hypertension and diabetes. In this context, lifestyle changes, such as diet modification, may prevent, delay, or limit the severity of hypertension, diabetes, and/or CKD. However, adherence to diet recommendations for CKD patients can be very challenging, and many studies report low adherence to renal dietary recommendations or a lack of improved adherence to interventions. High rates of multiple comorbidities, poor appetite, and food insecurity may also complicate diet adherence in CKD.
Medically tailored meals (MTMs) can help improve diet adherence and food insecurity. MTMs are specially formulated by dietitians to meet nutrient recommendations for individuals with kidney disease and other chronic diseases. MTMs can improve clinical outcomes and reduce healthcare costs in Veterans with CKD. MTMs have improved food security, quality of life, and readmission rates in non-VA patients with chronic diabetes and heart failure.
Our pilot MTM study in non-VA hemodialysis patients demonstrated improved renal dietary adherence among participants while significantly reducing blood pressure, fluid retention, and serum phosphorus. However, research has yet to examine whether MTMs can improve health outcomes or healthcare costs in the Veteran CKD population. This proposal addresses these gaps by employing qualitative methods to gain insight into barriers to renal diet adherence and MTMs as an intervention for Veterans with advanced CKD (stage 3b-5).
Funder: Seattle-Denver COIN HSR&D Small aWard Initiative For impacT (SWIFT) Grant
Recent Publications
2022
Perez L, You Z, Teitelbaum I, Andrews ES, Reddin R, Ramirez-Renteria L, Wilson G, Kendrick J. A 6-Month clinical practice pilot study of sucroferric oxyhydroxide on nutritional status in patients on peritoneal dialysis. BMC Nephrol. 2022 Jul 9;23(1):245. doi: 10.1186/s12882-022-02878-5. PMCID: PMC9271241. PMID: 35810296
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Martin M, Bansal A, Perez L, Stenson EK, Kendrick J. Use of Relative Blood Volume Monitoring to Reduce Intradialytic Hypotension in Hospitalized Patients Receiving Dialysis. Kidney Int Rep. 2022 Jul 4;7(9):2105-2107. doi: 10.1016/j.ekir.2022.06.018. PMCID: PMC9459027. PMID: 36090491
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Perez LM, Biruete A. Lack of Cultural and Language Concordant Nutrition Education for Hispanic/Latinx Individuals with CKD: A Call to Action. J Am Soc Nephrol. 2022 Jul;33(7):1262-1264. doi: 10.1681/ASN.2022040430. Epub 2022 May 11. PMCID: PMC9257809. PMID: 35545302
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Perez LM, Biruete A, Wilund KR. Home-delivered meals as an adjuvant to improve volume overload and clinical outcomes in hemodialysis. Clin Kidney J. 2022 Apr 19;15(10):1829-1837. doi: 10.1093/ckj/sfac102. PMCID: PMC9494523. PMID: 36158146
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Perez LM, Kendrick J. Practice What you Preach: The Kidney Diet Challenge. Kidney360. 2022 Feb 24;3(2):199-200. doi: 10.34067/KID.0006892021. PMCID: PMC8967626. PMID: 35373123
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2021
Harris AMY, Evans NM, Perez L, Burrows B, Derk GR, Chiu C, Wilund KR. Working on Wellness: Impact of a Pilot Workplace Wellness Program in a Hemodialysis Center. Nephrol Nurs J. 2021 Jan-Feb;48(1):49-55. PMID: 33683843
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Perez LM, Fang HY, Ashrafi SA, Burrows BT, King AC, Larsen RJ, Sutton BP, Wilund KR. Pilot study to reduce interdialytic weight gain by provision of low-sodium, home-delivered meals in hemodialysis patients. Hemodial Int. 2021 Apr;25(2):265-274. doi: 10.1111/hdi.12902. Epub 2020 Nov 4. PMID: 33150681
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2020
Perez LM, Burrows BT, Chan LE, Fang HY, Barnes JL, Wilund KR. Pilot feasibility study examining the effects of a comprehensive volume reduction protocol on hydration status and blood pressure in hemodialysis patients. Hemodial Int. 2020 Jul;24(3):414-422. doi: 10.1111/hdi.12841. Epub 2020 May 12. PMID: 32400085
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Wilund KR, Viana JL, Perez LM. A Critical Review of Exercise Training in Hemodialysis Patients: Personalized Activity Prescriptions Are Needed. Exerc Sport Sci Rev. 2020 Jan;48(1):28-39. doi: 10.1249/JES.0000000000000209. PMCID: PMC6910960. PMID: 31453844
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