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Dietary intakes of children with nephrotic syndrome

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Abstract

Background

Our multidisciplinary clinical pathway for treatment of childhood nephrotic syndrome (NS) was established with the goal of standardizing local clinical practice. This descriptive study aimed to assess nutrient intakes of children with newly diagnosed NS compared with nutrition goals defined by our pathway.

Methods

Our pathway includes evidence-based recommendations that target daily intakes during corticosteroid induction therapy: energy (Estimated Energy Requirements (EER) × Sedentary Physical Activity (PA)), sodium (1 mg/kcal), calcium (Dietary Reference Intake (DRI) + 500 mg elemental calcium), and vitamin D (DRI +800-1000 IU). After dietitian-led education at initial diagnosis, 3-day food records were completed at 4 weeks post-diagnosis. Daily nutrient intakes were compared to pathway targets and DRIs.

Results

Thirty-six children (median age 4.8 years, 44% female) with newly diagnosed NS submitted food records. Mean energy and sodium intakes were 103±22% and 99±53% of pathway targets, respectively. Fourteen (39%) children exceeded pathway sodium recommendations, with four (11%) exceeding them by greater than 50%. Seven (19%) children met DRI for calcium, while six (17 %) met pathway targets for calcium. No children met DRI for vitamin D from diet alone; and only one met the target with supplementation.

Conclusions

This is the first study to describe dietary intakes of children with newly diagnosed NS. Our clinical pathway targets for energy and sodium were achievable; however, calcium and vitamin D intakes fell short of pathway guidelines and DRIs. Prescription of supplemental calcium and vitamin D may be needed to achieve target intakes of calcium and vitamin D.

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Acknowledgements

We would like to acknowledge our patients and their families and the Clinical Pathway Development Team at the British Columbia Children’s Hospital.

Funding

This work was financially supported in part by the British Columbia Provincial Renal Agency.

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Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, British Columbia Children’s Hospital, University of British Columbia, Vancouver, BC, Canada

    Nonnie Polderman, Meredith Cushing, Kirsten McFadyen, Marisa Catapang, Robert Humphreys, Cherry Mammen & Douglas G. Matsell

  2. British Columbia Children’s Hospital, 4480 Oak Street, Room K4-169, Vancouver, BC, V6H 2V2, Canada

    Nonnie Polderman

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  1. Nonnie Polderman
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Correspondence to Nonnie Polderman.

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Polderman, N., Cushing, M., McFadyen, K. et al. Dietary intakes of children with nephrotic syndrome. Pediatr Nephrol 36, 2819–2826 (2021). https://doi.org/10.1007/s00467-021-05055-2

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  • DOI: https://doi.org/10.1007/s00467-021-05055-2

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