The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis-clinical practice recommendation from the Pediatric Renal Nutrition Taskforce

被引:49
|
作者
McAlister, Louise [1 ]
Pugh, Pearl [2 ]
Greenbaum, Laurence [3 ]
Haffner, Dieter [4 ]
Rees, Lesley [1 ]
Anderson, Caroline [5 ]
Desloovere, An [6 ]
Nelms, Christina [7 ]
Oosterveld, Michiel [8 ]
Paglialonga, Fabio [9 ]
Polderman, Nonnie [10 ]
Qizalbash, Leila [11 ]
Renken-Terhaerdt, Jose [12 ]
Tuokkola, Jetta [13 ]
Warady, Bradley [14 ]
Walle, Johan Vande [6 ]
Shaw, Vanessa [1 ,15 ]
Shroff, Rukshana [1 ]
机构
[1] UCL, Great Ormond St Hosp Children NHS Fdn Trust, Inst Child Hlth, WC1N 3JH, London, England
[2] Nottingham Univ Hosp NHS Trust, Nottingham Childrens Hosp, Nottingham, England
[3] Emory Univ, Childrens Healthcare Atlanta, Atlanta, GA USA
[4] Childrens Hosp, Hannover Med Sch, Hannover, Germany
[5] Univ Hosp Southampton NHS Fdn Trust, Southampton Childrens Hosp, Southampton, England
[6] Univ Hosp Ghent, Ghent, Belgium
[7] Univ Nebraska, PedsFeeds LLC, Nebraska, NE USA
[8] Amsterdam Univ Med Ctr, Emma Childrens Hosp, Amsterdam, Netherlands
[9] Fdn IRCCS CaGranda Osped Maggiore Policlin, Milan, Italy
[10] British Columbia Childrens Hosp, Vancouver, BC, Canada
[11] Great No Childrens Hosp, Newcastle Upon Tyne, England
[12] Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Utrecht, Netherlands
[13] Univ Helsinki, Helsinki Univ Hosp, Childrens Hosp, Clin Nutr Unit, Helsinki, Finland
[14] Childrens Mercy Kansas City, Kansas City, MO USA
[15] Univ Plymouth, Univ Coll London Inst Child Hlth, London, England
关键词
Calcium; Phosphate; Nutrition; Chronic kidney disease (CKD); Children; CHRONIC KIDNEY-DISEASE; BONE-MINERAL DENSITY; FOOD-FREQUENCY QUESTIONNAIRE; GROWTH-FACTOR; 23; VITAMIN-D; VASCULAR CALCIFICATION; PHOSPHORUS INTAKE; HEALTH IMPACT; METABOLISM; CHILDHOOD;
D O I
10.1007/s00467-019-04370-z
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
In children with chronic kidney disease (CKD), optimal control of bone and mineral homeostasis is essential, not only for the prevention of debilitating skeletal complications and achieving adequate growth but also for preventing vascular calcification and cardiovascular disease. Complications of mineral bone disease (MBD) are common and contribute to the high morbidity and mortality seen in children with CKD. Although several studies describe the prevalence of abnormal calcium, phosphate, parathyroid hormone, and vitamin D levels as well as associated clinical and radiological complications and their medical management, little is known about the dietary requirements and management of calcium (Ca) and phosphate (P) in children with CKD. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists, who develop clinical practice recommendations (CPRs) for the nutritional management of various aspects of renal disease management in children. We present CPRs for the dietary intake of Ca and P in children with CKD stages 2-5 and on dialysis (CKD2-5D), describing the common Ca- and P-containing foods, the assessment of dietary Ca and P intake, requirements for Ca and P in healthy children and necessary modifications for children with CKD2-5D, and dietary management of hypo- and hypercalcemia and hyperphosphatemia. The statements have been graded, and statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. These CPRs will be regularly audited and updated by the PRNT.
引用
收藏
页码:501 / 518
页数:18
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