What are the phosphorus and calcium requirements for children with chronic kidney disease (CKD)?

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

As the glomerular filtration rate (GFR) progressively declines, excretion of phosphate decreases, and, hence, serum phosphorus levels increase. Because of this process, care must be taken for the following:

  • Dietary phosphorus restriction

  • Regular phosphate binders with the meals

The elemental calcium intake recommended for pediatric patients with chronic kidney disease is as follows:

  • Age 1-10 years: 500-600 mg/d

  • Age 11-18 years: 800-1000 mg/d

High amounts of phosphorus affect growth in children and, if the levels are high over a long period, may cause renal osteodystrophy. Prolonged elevation of serum calcium and phosphorus levels leads to vascular calcification. The daily elemental calcium requirement is about 80-100 mg/kg/d.


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