Dietary sources of energy and nutrient intake among children and adolescents with chronic kidney disease

  • Wen Chen
  • Kirstie Ducharme-Smith
  • Laura Davis
  • Wun Fung Hui
  • Bradley A. Warady
  • Susan L. Furth
  • Alison G. Abraham
  • Aisha Betoko
Original Article

DOI: 10.1007/s00467-017-3580-0

Cite this article as:
Chen, W., Ducharme-Smith, K., Davis, L. et al. Pediatr Nephrol (2017). doi:10.1007/s00467-017-3580-0

Abstract

Background

Our purpose was to identify the main food contributors to energy and nutrient intake in children with chronic kidney disease (CKD).

Methods

In this cross-sectional study of dietary intake assessed using Food Frequency Questionnaires (FFQ) in the Chronic Kidney Disease in Children (CKiD) cohort study, we estimated energy and nutrient intake and identified the primary contributing foods within this population.

Results

Completed FFQs were available for 658 children. Of those, 69.9% were boys, median age 12 (interquartile range (IQR) 8–15 years). The average daily energy intake was 1968 kcal (IQR 1523–2574 kcal). Milk was the largest contributor to total energy, protein, potassium, and phosphorus intake. Fast foods were the largest contributors to fat and sodium intake, the second largest contributors to energy intake, and the third largest contributors to potassium and phosphorus intake. Fruit contributed 12.0%, 8.7%, and 6.7% to potassium intake for children aged 2–5, 6–13, and 14–18 years old, respectively.

Conclusions

Children with CKD consumed more sodium, protein, and calories but less potassium than recommended by the National Kidney Foundation (NKF) guidelines for pediatric CKD. Energy, protein, and sodium intake is heavily driven by consumption of milk and fast foods. Limiting contribution of fast foods in patients with good appetite may be particularly important for maintaining recommended energy and sodium intake, as overconsumption can increase the risk of obesity and cardiovascular complications in that population.

Keywords

Nutrient intakeFoodChildrenAdolescentsChronic kidney disease

Abbreviations

AI

Adequate intake

CKiD

Chronic Kidney Disease in Children

CKD

Chronic kidney disease

DSN

Dietary sources of nutrients

eGFR

Estimated glomerular filtration rate

EER

Estimated energy requirement

FFQ

Food Frequency Questionnaire

IQR

Interquartile range

NHANES

National Health and Nutrition Examination Survey

NKF

National Kidney Foundation

RDA

Recommended dietary allowance

Supplementary material

467_2017_3580_MOESM1_ESM.docx (44 kb)
ESM 1(DOCX 44 kb)

Copyright information

© IPNA 2017

Authors and Affiliations

  • Wen Chen
    • 1
    • 2
  • Kirstie Ducharme-Smith
    • 3
  • Laura Davis
    • 3
  • Wun Fung Hui
    • 4
  • Bradley A. Warady
    • 2
  • Susan L. Furth
    • 4
    • 5
  • Alison G. Abraham
    • 6
    • 7
  • Aisha Betoko
    • 6
  1. 1.Department of Nutrition and Food Hygiene, School of Public HealthTianjin Medical UniversityTianjinChina
  2. 2.Division of Pediatric NephrologyChildren’s Mercy HospitalKansas CityUSA
  3. 3.Johns Hopkins HospitalBaltimoreUSA
  4. 4.Department of PediatricsThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  5. 5.Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  6. 6.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  7. 7.Department of OphthalmologyJohns Hopkins School of MedicineBaltimoreUSA