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Nutrition in infants and very young children with chronic kidney disease

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Abstract

Provision of adequate nutrition is a cornerstone of the management of infants and very young children with chronic kidney disease (CKD). Very young children with CKD frequently have poor spontaneous nutritional intake. Because growth depends strongly on nutrition during early childhood, growth in very young children with CKD is often suboptimal. In this review we will consider the mechanisms and manifestations of inadequate nutritional status in very young children with CKD, mechanisms mediating inadequate nutritional intake, and the optimal nutritional management of this special population. In addition, we suggest an approach to the assessment of nutritional status, including the use of body mass index in infants. Five major nutritional components are considered: energy, macronutrients, fluids and electrolytes, micronutrients, and calcium/phosphorus/vitamin D. The use of adjunctive therapies, including appetite stimulants, treatment of gastroesophageal reflux and gastric dysmotility, enhanced dialytic clearance, and growth hormone, is also briefly discussed.

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Acknowledgements

BJF is supported by the Fonds de la recherche en santé du Québec. RHM is supported by the National Institute of Health U01 DK-3-012 grant.

All authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Division of Nephrology, Department of Pediatrics, Montreal Children’s Hospital, McGill University Health Centre, 2300 Tupper Street, Montreal, Quebec, H3H 1P3, Canada

    Bethany J. Foster

  2. Department of Clinical Nutrition, Montreal Children’s Hospital, McGill University Health Centre, Montreal, Quebec, Canada

    Lynn McCauley

  3. Division of Nephrology, Department of Pediatrics, Rady Children’s Hospital, University of California San Diego, San Diego, CA, USA

    Robert H. Mak

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  1. Bethany J. Foster
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  2. Lynn McCauley
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Correspondence to Bethany J. Foster.

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Foster, B.J., McCauley, L. & Mak, R.H. Nutrition in infants and very young children with chronic kidney disease. Pediatr Nephrol 27, 1427–1439 (2012). https://doi.org/10.1007/s00467-011-1983-x

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