Caramel Apple Salad by Darlene from Michigan

There's something about the blending of tart and sweet flavors that's really satisfying. DaVita renal dietitian Darlene from Michigan has come up with a family-favorite recipe that combines a small amount of crunchy peanuts and tart Granny Smith apples with sweet butterscotch flavor. This is the kind of side dish that makes any meal a special occasion. And because it's kidney-friendly, it's not off-limits to those concerned about kidney health.

Michigan native Darlene was first introduced to dietetics while in high school. As a co-op student, she worked for a dietitian and so was able to see first-hand what a dietitian does. But at that time, her career goal was to become a pharmacist. Later, while attending Central Michigan University, Darlene worked in a pharmacy that was located within a grocery store. She observed that people would come in to fill prescriptions for medications to fight high cholesterol and high blood pressure, yet they were shopping for high-fat, high-sodium and high-cholesterol foods.

About this same time, Darlene's father was diagnosed with diabetes. Because he didn't make the recommended dietary changes, he ended up in the emergency room with a blood sugar of 950 and came out of the hospital on insulin. "I found it slightly unsettling watching my father and many patients use so many medications without making any dietary changes," Darlene remembers. "I felt that more could be done to help prevent the diseases or slow the progression by using both diet and medications. This was a major factor in my change in career path to dietetics!"

Darlene's decision to enter the renal field came after she had been working for a while as a dietitian. "I had always wanted to specialize in one area of nutrition and was becoming frustrated with the little impact I could make on the patients I was seeing in my hospital job working as an acute care dietitian," she explains.

As a renal dietitian, Darlene knows that kidney patients need to be motivated in order to make changes to protect their health. And she admits that helping people find that motivation or desire to make the needed lifestyle changes for living with kidney disease is the most challenging aspect of her job.

So how does Darlene help her patients help themselves? "I try to help a patient problem-solve to make reasonable goals to achieving their optimal health status," explains Darlene.

The highpoint for Darlene is when she witnesses positive outcomes. "Sharing in a patient’s success, from getting their phosphorus in goal, to getting an AVF (arterial-venous fistula) placed – those are the most rewarding moments of my job!" declares Darlene.

This DaVita dietitian especially enjoys the chance to collaborate with patients over time. "I love the follow-up that comes with working with a patient long-term versus just the short interaction that a hospital dietitian has," Darlene explains.

In her collaboration with patients, Darlene takes a relaxed, friendly approach. "I think trust is important when building rapport with patients," she states. "Once your relationship is established, it’s easier to conquer some of the dietary/health problems."

When mentoring her patients, Darlene emphasizes their own involvement. "Be proactive with all aspects of your care, and never be afraid to ask your physician or health care provider any question or discuss any concern that you may have," Darlene advises her kidney patients.

Darlene has been with DaVita for three years now and loves the collegial atmosphere of the center. "Everyone at my clinic is very warm and friendly, both patients and teammates, which makes my workday much more pleasant!" says Darlene.

The most surprising thing she's discovered while working with DaVita is the shortage of organ donors. "I was truly surprised to learn about the lack of available organs/organ donors, leading to the long waits on the transplant list," Darlene explains. "I registered as a donor within my first six months of working with DaVita."

In her role as part of a health care team, Darlene is able to relate to patients on a personal level since she herself has a chronic health condition. She explains that although it is not as significant as being on dialysis, it still helps her bond with her patients. Darlene remembers one young patient, 21 years old, who was feeling overwhelmed when he began treatment for kidney disease. "I was able to talk about some of his frustrations about living with a chronic disease," Darlene recalls. "Obviously, we also discussed diet at length, as he was not used to having any dietary restrictions at all."

The young man was on dialysis for about one year before he received a kidney transplant from his sister. Unfortunately, his body rejected the kidney, and he had to return to hemodialysis after only a few months. Darlene encountered him one day after his return to dialysis. She had a dietetic intern with her, and the young man looked at the intern and said, “Listen to her! She taught me everything I needed to know about eating right, and I’m still following my diet!”

These heartfelt words touched Darlene. "As a dietitian, so often we are looked at as the 'food police' or the person taking away the last bits of pleasure from someone," she states. "Hearing that patient say that I helped him was truly one of my favorite moments working as a dietitian."

Take a tip from dedicated renal dietitian Darlene from Michigan and perk up a ho-hum meal with tart-yet-sweet Caramel Apple Salad. Be sure to make plenty, as this is a real crowd-pleaser that can be enjoyed by everyone, even those with kidney problems. Everyone at your dinner table will thank you!

Caramel Apple Salad

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