The ADA was organized at a meeting of 58 professionals in October of 1917 in Cleveland, Ohio. Present at that first meeting was Ruth Wheeler from the University of Illinois. During her term of office as president 8 years later, she founded the Journal of the American Dietetic Association (JADA). Volume 2 of JADA was published in 1926 where the majority of articles were related to renal nutrition. The first article about renal nutrition was written by Dr. John Peters and discussed the use of a very low protein or no protein diet for only short period of time, and a moderate amount of salt "to spare the patient a certain amount of discomfort" (53). In the spring of 1927, two dietitians, Florence H. Smith and Mary Whelan along with Dr. Keith Norman, reported on 165 cases encountered during the prior 3 years where a diet restricted in both salt and water proved effective in treating edema due to nephritis at the Mayo Clinic (32). Another dietitian, Fairfax T. Proudfit reviewed a patient case with diabetes complications resulting from kidney disease (54). By this time, there were approximately 1000 members of the ADA, and because this Journal was a membership benefit, these articles served to educate practitioners who probably did not have access to other educational materials about kidney disease. All aspects of kidney disease and its treatment have continued to be covered on a regular basis in JADA.
In the 1980s, the ADA Commission on Dietetic Registration began to examine areas of specialization in dietetic practice by reviewing published education materials and consistency in practice patterns (55). Role Delineation Studies were conducted that showed that the care of patients with kidney disease required advanced knowledge and the performance of specific tasks unique to this patient population. These studies became the basis for Board Certification as a Specialist in Renal Nutrition. Renal dietitians were one of the first groups selected to participate in this process. This certification is granted in recognition of an applicant's documented practice experience and successful completion of a clinical problem simulation examination in the specialty area (55). The first Board Certified Specialists in Renal Nutrition (CSR) were announced in early 1994.
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