Meat and Rice Balls by Ken from Missouri 

Porcupine Balls are whimsically named for the white rice in them that sticks up out of the meatballs like quills. Submitted by DaVita renal dietitian, Ken from Missouri, and modified from a family recipe, we’ve given this kidney-friendly food a name more descriptive of its ingredients: Meat and Rice Balls.

Originally from Crystal City, Missouri, Ken says he always found nutrition fascinating, and at a young age realized that many people were not following recommendations from the USDA Food Guide Pyramid. “I wanted to learn more about nutrition,” he comments, “specifically, to learn more about the interaction between nutrition and athletic performance. As I dove deeper into my career, I found that I had more of a passion for medical nutrition therapy and wellness than for sports nutrition.”

During Ken’s final year of college as an undergraduate at Southeast Missouri State University, an opportunity arose at a local dialysis facility. He worked there for just under a year as a dietitian's assistant, and it kept him interested in looking for dialysis job opportunities. Ken completed his internship and graduate studies at Saint Louis University.

Now employed with DaVita for ten months, Ken mentions that the most challenging aspect of his job is helping patients understand the importance of nutrition, and more specifically, the importance of eating an adequate amount of calories. “Many of our dialysis patients have had poor eating habits all of their adult lives,” Ken comments, “and simply telling them what foods to eat is just not enough. They need to change their habits, such as how often they eat, how much they eat at one meal or snack and then work forward with food choices. Not the other way around.”

The most rewarding aspect of the job, according to Ken, is seeing a dialysis patient's attitude and overall demeanor improve while concurrently seeing their albumin improve. (Albumin is a protein routinely measured that indicates a person’s level of nutrition.) “The power of nutrition!” Ken enthuses. “I make a difference in my dialysis patients’ lives by helping them understand that nutrition doesn't just keep them alive and healthy. Eating right really improves quality of life.”

Ken suggests protein supplements for all new patients during their initial dialysis diet instruction. He mentions that new dialysis patients seem to be more receptive, and are more willing to try a variety of products to find one they like. “Gradually, this seems to be helping all of our patients to acquire adequate protein and improved albumin levels.”

Ken tells the story of a patient who really struggled with his albumin, and for the first few months after Ken started working at the facility, he would tell him, “Just stick with me, I'll do better.” Ken says,” I’d always tell him ‘I'm not going to give up on you, just give me a sign that you're trying to eat better.’ Over the next few months his albumin and appetite gradually declined, until he ultimately was hospitalized for weakness, fatigue and malnutrition. After a long hospitalization and stay at a nursing home, he started coming to his dialysis treatments again and thanked me for continuing to give him ideas about ways to increase his caloric intake. At the hospital, they told him how close he was to ‘checking out.’ He said he kept thinking about our talks and decided he was going to make a fight of it! After struggling with multiple infections in his leg, his albumin has gradually started to improve. He is looking more nourished and has a more energetic affect. Each week during rounds with his nephrologist he makes a point to thank me and tell his doctor how much I've helped him. I always look forward to rounds for that shift!”

Ken is happy to be working in the dialysis center. “I enjoy working with the same patients. I enjoy the continuity of care that our health care team is able to provide. Because I grew up in the area, I can relate to a lot of the foods and habits that our patients have. It really helps me identify where they're coming from, and makes it easier to make suggestions to help them change their habits,” he shares.

Ken describes his working approach as one of as few restrictions as possible. “This means that whenever possible, I don’t use the words ‘don't eat that’ or ‘stay away from that,’” he comments. “I provide the information dialysis patients need to know related to phosphorus, potassium, protein, fluid, sodium, etc. I make suggestions on how to meet their lab goals, and most importantly, give them specific examples of what foods they can enjoy and in what amounts. I have found that most of our dialysis patients are open to this, as they feel fewer restrictions.”

In Ken’s opinion, the single most important thing kidney patients can do to improve their health relates to the timing of meals.For the patients at our dialysis facility, I advise eating at least three small meals with 1 to 3 snacks each day. Most patients may only eat 1 to 2 large meals per day (sometimes with non-nutritive snacks) and make it difficult for their bodies to adequately utilize calories, protein and other nutrients. Similarly, the amount of phosphorus binders their nephrologists have prescribed is based on the assumption that they are eating three times a day, with phosphorus intake spread out. Often, their phosphorus intake is piled into 1 or 2 meals and the prescribed amount of phosphorus binders is inadequate.”

Ken really enjoys working with the facility administrator at his dialysis center, and the atmosphere and compassion she brings to the facility. “She is a joy to work with,” Ken says, “and works hard to instill the DaVita values in all of our teammates.” A deep level of compassion makes the facility a pleasant environment for the patients, Ken feels. The laughter and interaction that occurs between teammates and patients is what he enjoys the most.

Put Ken’s Meat and Rice Balls, a.k.a., Porcupine Balls, on your kidney-friendly lunch or dinner menu and see everyone’s delight at this tasty and fun food. Remember to take Meat and Rice Balls to your next party. No one will guess they’re kidney friendly, and you’ll have a delicious food you can enjoy that’s on your dialysis diet plan.



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