Energy and protein requirements for children with CKD stages 2-5 and on dialysis-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce.

Abstract

Dietary management in pediatric chronic kidney disease (CKD) is an area fraught with uncertainties and wide variations in practice. Even in tertiary pediatric nephrology centers, expert dietetic input is often lacking. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, was established to develop clinical practice recommendations (CPRs) to address these challenges and to serve as a resource for nutritional care. We present CPRs for energy and protein requirements for children with CKD stages 2-5 and those on dialysis (CKD2-5D). We address energy requirements in the context of poor growth, obesity, and different levels of physical activity, together with the additional protein needs to compensate for dialysate losses. We describe how to achieve the dietary prescription for energy and protein using breastmilk, formulas, food, and dietary supplements, which can be incorporated into everyday practice. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgment. Research recommendations have been suggested. The CPRs will be regularly audited and updated by the PRNT.

• Authors: Vanessa Shaw, Nonnie Polderman, José Renken-Terhaerdt, Fabio Paglialonga, Michiel Oosterveld, Jetta Tuokkola, Caroline Anderson, An Desloovere, Laurence Greenbaum, Dieter Haffner, Christina Nelms, Leila Qizalbash, Johan Vande Walle, Bradley Warady, Rukshana Shroff, Lesley Rees
• Journal: Pediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 35 Issue 3 Pg. 519-531 (03 2020) ISSN: 1432-198X [Electronic] Germany
• PMID: 31845057 (Publication Type: Journal Article, Practice Guideline, Research Support, Non-U.S. Gov't)

Chemical References

• Dietary Proteins

Topics

• Child
• Child Development (physiology)
• Child Nutritional Physiological Phenomena
• Dietary Proteins (administration & dosage)
• Dietary Supplements (standards)
• Energy Metabolism (physiology)
• Humans
• Kidney Failure, Chronic (complications, therapy)
• Nephrology (methods, standards)
• Nutritional Requirements
• Nutritional Support (methods, standards)
• Pediatrics (methods, standards)
• Renal Dialysis (adverse effects)