Nutrition in children with CRF and on dialysis

Abstract

The objectives of this study are: (1) to understand the importance of nutrition in normal growth; (2) to review the methods of assessing nutritional status; (3) to review the dietary requirements of normal children throughout childhood, including protein, energy, vitamins and minerals; (4) to review recommendations for the nutritional requirements of children with chronic renal failure (CRF) and on dialysis; (5) to review reports of spontaneous nutritional intake in children with CRF and on dialysis; (6) to review the epidemiology of nutritional disturbances in renal disease, including height, weight and body composition; (7) to review the pathological mechanisms underlying poor appetite, abnormal metabolic rate and endocrine disturbances in renal disease; (8) to review the evidence for the benefit of dietetic input, dietary supplementation, nasogastric and gastrostomy feeds and intradialytic nutrition; (9) to review the effect of dialysis adequacy on nutrition; (10) to review the effect of nutrition on outcome.

Late referral to paediatric renal failure service impairs access to pre-emptive kidney transplantation in children

“…Dialysis is associated with the need for vascular or peritoneal access, difficulties in nutritional care, metabolic disturbances, poor school attendance and other limitations in familial and social activity 14–16. In addition, there is an increasing awareness of long-term risks of extended dialysis duration in children, including increased risk of bone disease and cardiovascular morbidity 17–20.…”

Long-term outcome of chronic dialysis in children

“…In a recent teaching article for Pediatric Nephrology , Rees and Shaw discussed at length the importance of nutrition and growth in CKD patients [47]; however, some pertinent points regarding the long-term outcome are mentioned here.…”

Optimizing Enteral Nutrition for Growth in Pediatric Chronic Kidney Disease (CKD)

“…The Kidney Disease Outcomes Quality Initiatives (KDOQI) pediatric nutrition guideline, considered a foundation for clinical nutrition care and practice for individuals with CKD, highlight several factors influencing the need for nutritional adjustment in children with CKD, including age, developmental stage, treatment or dialysis modality, residual kidney function, comorbidities, prematurity, decreased appetites or energy intake, acidosis, sodium losses, mineral bone disorders, and abnormalities in the growth hormone-insulin like growth factor axis (1, 2, 4). Poor growth has serious consequences, including hospitalization, mortality and poor quality of life (5).…”