NUTRITIONAL SUPPORT FOR YOUNG CHILDREN BEFORE KIDNEY TRANSPLANTATION

Abstract

Dietary management for toddlers, preparing for kidney transplantation (KT) is full of uncertainty, as randomized controlled trials are extremely difficult in pediatrics for several reasons. Currently, there are only a few organizations in the world that are developing clinical recommendations for nutrition in patients with stages 2-5 and 5D of chronic kidney disease (CKD). Since 2015, the first steps have been taken to harmonize approaches and practical recommendations, due to the combined efforts of international working groups. However, most global associations of clinicians and researchers generally do not provide recommendations on nutritional support in children with 2-5 stages of chronic kidney disease (CKD) receiving hemodialysis or peritoneal dialysis. This work highlights the daily requirements for calories, proteins, and micronutrients for children with CKD stages 2-5 and 5D, taking into account physical development, protein energy deficiency, obesity and various levels of physical activity, as well as additional protein requirements to compensate for dialysis losses and optimal feeding methods. The review is based on data from international working groups that develop nutritional recommendations for children with stages 2-5 and 5D of CKD: KDOQI (Kidney Disease Outcomes Quality Initiative), PRNTL (Pediatric Renal Nutrition Taskforce), CARI (Caring for Australians with Renal Impairment), NAPRTCS (North American Pediatric Renal Transplant Cooperative Study), EPDWG (The European Pediatric Peritoneal Dialysis Working Group), as well as individual studies in this field.