scholarly journals Delivery of a nutritional prescription by enteral tube feeding in children with chronic kidney disease stages 2–5 and on dialysis—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

2020 ◽  
Vol 36 (1) ◽  
pp. 187-204
Author(s):  
Lesley Rees ◽  
◽  
Vanessa Shaw ◽  
Leila Qizalbash ◽  
Caroline Anderson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Growth Parameters ◽  
Tube Feeding ◽  
Low Grade ◽  
Enteral Tube Feeding ◽  
Practice Recommendations ◽  
The Individual ◽  
Disease Stages

AbstractThe nutritional prescription (whether in the form of food or liquid formulas) may be taken orally when a child has the capacity for spontaneous intake by mouth, but may need to be administered partially or completely by nasogastric tube or gastrostomy device (“enteral tube feeding”). The relative use of each of these methods varies both within and between countries. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) based on evidence where available, or on the expert opinion of the Taskforce members, using a Delphi process to seek consensus from the wider community of experts in the field. We present CPRs for delivery of the nutritional prescription via enteral tube feeding to children with chronic kidney disease stages 2–5 and on dialysis. We address the types of enteral feeding tubes, when they should be used, placement techniques, recommendations and contraindications for their use, and evidence for their effects on growth parameters. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgement. Research recommendations have been suggested. The CPRs will be regularly audited and updated by the PRNT.

scholarly journals Clinical practice recommendations for treatment with active vitamin D analogues in children with chronic kidney disease Stages 2–5 and on dialysis

2017 ◽  
Vol 32 (7) ◽  
pp. 1114-1127 ◽  
Author(s):  
Rukshana Shroff ◽  
Mandy Wan ◽  
Evi V. Nagler ◽  
Sevcan Bakkaloğlu ◽  
Mario Cozzolino ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Active Vitamin ◽  
Practice Recommendations ◽  
Active Vitamin D ◽  
Vitamin D Analogues ◽  
Disease Stages

scholarly journals Clinical practice recommendations for native vitamin D therapy in children with chronic kidney disease Stages 2–5 and on dialysis

2017 ◽  
Vol 32 (7) ◽  
pp. 1098-1113 ◽  
Author(s):  
Rukshana Shroff ◽  
Mandy Wan ◽  
Evi V. Nagler ◽  
Sevcan Bakkaloğlu ◽  
Dagmar-C. Fischer ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Practice Recommendations ◽  
Disease Stages

scholarly journals Clinical practice recommendations for the care of infants with stage 5 chronic kidney disease (CKD5)

2012 ◽  
Vol 28 (9) ◽  
pp. 1739-1748 ◽  
Author(s):  
Aleksandra M. Zurowska ◽  
◽  
Michel Fischbach ◽  
Alan R. Watson ◽  
Alberto Edefonti ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Practice Recommendations

scholarly journals Catch-up growth in children with chronic kidney disease started on enteral feeding after 2 years of age

2019 ◽  
Vol 35 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Matko Marlais ◽  
Jelena Stojanovic ◽  
Helen Jones ◽  
Shelley Cleghorn ◽  
Lesley Rees
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Kidney Disease ◽  
Enteral Feeding ◽  
Tube Feeding ◽  
Prepubertal Children ◽  
Enteral Tube Feeding ◽  
Catch Up ◽  
Second Year ◽  
First Time

Abstract Background Enteral feeding by tube in chronic kidney disease (CKD) before 2 years of age improves growth. Whether it is effective after this age is unknown. We assessed whether height and weight SDS changed after tube feeding was started in children with CKD above 2 years of age. Methods Retrospective study of pre-transplant, pre-pubertal children (< 11 years) with CKD stages 2–5 started on nasogastric tube or gastrostomy feeds for the first time after age 2 years. Children were identified by searching dietetic records and the renal database. Children on growth hormone were excluded. Height, weight, and BMI were documented 1 year prior to and at the start of tube feeds, and after 1 and 2 years. Data collection ceased at transplantation. Results Fifty children (25 male) were included. The median (range) age at start of tube feeds was 5.6 (2.1–10.9) years. Sixteen children were dialysed (1 haemodialysis, 15 peritoneal dialysis); 34 predialysis patients had a median (range) eGFR of 22 (6–88) ml/min/1.73 m2. Overall height SDS (Ht SDS) improved from − 2.39 to − 2.27 at 1 year and − 2.18 after 2 years (p = 0.02). BMI SDS improved from − 0.72 to 0.23 after 1 year and was 0.09 after 2 years of enteral feeding (p < 0.0001). Height SDS improved more in children aged 2–6 years (− 2.13 to − 1.68, p = 0.03) and in children not on dialysis (− 2.33 to − 1.99, p = 0.002). Conclusions Enteral tube feeding commenced after 2 years of age in prepubertal children with CKD improves height and weight SDS, with stability of BMI during the second year. Younger children and those not on dialysis had the greatest benefit.

scholarly journals Clinical practice recommendations for growth hormone treatment in children with chronic kidney disease

2019 ◽  
Vol 15 (9) ◽  
pp. 577-589 ◽  
Author(s):  
Jens Drube ◽  
◽  
Mandy Wan ◽  
Marjolein Bonthuis ◽  
Elke Wühl ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Growth Hormone Treatment ◽  
Hormone Treatment ◽  
Practice Recommendations

scholarly journals Energy and protein requirements for children with CKD stages 2-5 and on dialysis–clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

2019 ◽  
Vol 35 (3) ◽  
pp. 519-531 ◽  
Author(s):  
Vanessa Shaw ◽  
Nonnie Polderman ◽  
José Renken-Terhaerdt ◽  
Fabio Paglialonga ◽  
Michiel Oosterveld ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Judgment ◽  
Pediatric Nephrology ◽  
Low Grade ◽  
Poor Growth ◽  
Protein Requirements ◽  
Practice Recommendations ◽  
Additional Protein ◽  
The Individual ◽  
Research Recommendations

AbstractDietary management in pediatric chronic kidney disease (CKD) is an area fraught with uncertainties and wide variations in practice. Even in tertiary pediatric nephrology centers, expert dietetic input is often lacking. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, was established to develop clinical practice recommendations (CPRs) to address these challenges and to serve as a resource for nutritional care. We present CPRs for energy and protein requirements for children with CKD stages 2–5 and those on dialysis (CKD2–5D). We address energy requirements in the context of poor growth, obesity, and different levels of physical activity, together with the additional protein needs to compensate for dialysate losses. We describe how to achieve the dietary prescription for energy and protein using breastmilk, formulas, food, and dietary supplements, which can be incorporated into everyday practice. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgment. Research recommendations have been suggested. The CPRs will be regularly audited and updated by the PRNT.

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