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

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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.

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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

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Acknowledgements

Data in this manuscript were collected by the Chronic Kidney Disease in Children prospective cohort study (CKiD) with clinical coordinating centers (principal investigators) at Children’s Mercy Hospital and the University of Missouri–Kansas City (Bradley Warady, MD, USA) and Children’s Hospital of Philadelphia (Susan Furth), Central Biochemistry Laboratory (George Schwartz) at the University of Rochester Medical Center, and data coordinating center (Alvaro Muñoz) at the Johns Hopkins Bloomberg School of Public Health. The CKiD Study is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Heart, Lung, and Blood Institute (U01-DK-66143, U01-DK-66174, U01DK-082194, U01-DK-66116). The CKiD website is located at https://www.statepi.jhsph.edu/ckid. We also acknowledge the China Scholarship Council for funding support to Wen Chen.

Author information

Authors and Affiliations

  1. Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China

    Wen Chen

  2. Division of Pediatric Nephrology, Children’s Mercy Hospital, Kansas City, MO, USA

    Wen Chen & Bradley A. Warady

  3. Johns Hopkins Hospital, Baltimore, MD, USA

    Kirstie Ducharme-Smith & Laura Davis

  4. Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Wun Fung Hui & Susan L. Furth

  5. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Susan L. Furth

  6. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA

    Alison G. Abraham & Aisha Betoko

  7. Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Alison G. Abraham

Authors
  1. Wen Chen
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  2. Kirstie Ducharme-Smith
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  3. Laura Davis
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  6. Susan L. Furth
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  8. Aisha Betoko
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Corresponding author

Correspondence to Aisha Betoko.

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Ethical statement

The study design and conduct were approved by an external study monitoring board appointed by the National Institute of Diabetes and Digestive and Kidney Diseases and by the institutional review boards of each participating center.

Conflict of interest

None of the authors declare a conflict of interest.

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Chen, W., Ducharme-Smith, K., Davis, L. et al. Dietary sources of energy and nutrient intake among children and adolescents with chronic kidney disease. Pediatr Nephrol 32, 1233–1241 (2017). https://doi.org/10.1007/s00467-017-3580-0

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  • DOI: https://doi.org/10.1007/s00467-017-3580-0

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