What is the role of dietary modifications in the treatment of chronic kidney disease (CKD) in children?

Updated: Jul 21, 2020
  • Author: Sanjeev Gulati, MD, MBBS, DNB(Peds), DM, DNB(Neph), FIPN(Australia), FICN, FRCPC(Canada); Chief Editor: Craig B Langman, MD  more...
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Answer

Dietary management is of paramount importance in children with chronic kidney disease (CKD). These patients have an altered metabolic milieu due to deranged kidney function. The challenge for pediatricians is to optimize the growth and development of children in this setting.

Nutritional management is one of the most important components of care for children with CKD that can improve key outcomes. Aggressive control of hypertension; correction of metabolic acidosis, water, and electrolyte abnormalities; and preventing episodes of acute on chronic kidney injury appear to constitute the most promising strategies. Effective dietary support requires the coordinated team efforts of a pediatric nephrologist, a pediatric renal dietitian, a social worker, the primary care provider, and the family.

In a cross-sectional study of dietary intake assessed by food frequency questionnaire (FFQ) in the North American Chronic Kidney Disease in Children (CKiD) prospective cohort study, children in the CKiD cohort were found to consume more sodium, phosphorus, protein, and calories than recommended. The gap between actual consumption and recommendations indicates a need for improved nutritional counseling and monitoring. [30]

The challenge for both pediatricians and dietitians is to make the diet interesting and palatable in order to ensure compliance. The goal is not only to add years to life but also to add life to years.


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