Assessment and management of vitamin status in children with CKD stages 2–5, on dialysis and post-transplantation: clinical practice points from the Pediatric Renal Nutrition Taskforce

• DOI: 10.1007/s00467-024-06303-x
• Publication Date: 2024-04-04T02:01:46Z
• Authors: Caroline E. Anderson; Jetta Tuokkola; Leila Qizalbash; Matthew Harmer; Christina L. Nelms; Stella Stabouli; Barry Toole; Nonnie Polderman; An Desloovere; Jose Renken-Terha...; Molly R. Wong Vega; Evelien Snauwaert; Johan Vande Walle; Dieter Haffner; Fabio Paglialonga; Rukshana Shroff; Vanessa Shaw; Larry A. Greenbaum; Bradley A. Warady
• Keywords: Nephrology; Medical nutrition therapy

Abstract Children with chronic kidney disease (CKD) are at risk for vitamin deficiency or excess. Vitamin status can be affected by diet, supplements, function, medications, and dialysis. Little is known about requirements in CKD, leading to practice variation. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric dietitians nephrologists, was established develop evidence-based clinical points (CPPs) address challenges serve as a resource nutritional care. Questions were formulated using PICO (Patient, Intervention, Comparator, Outcomes), literature searches undertaken explore from assessment management children CKD stages 2–5, on dialysis post-transplantation (CKD2-5D&T). CPPs developed finalized Delphi consensus approach. We present six CKD2-5D&T. assessment, intervention, monitoring. recommend avoiding supplementation A suggest water-soluble those In the absence evidence, consistent structured approach that considers monitoring dietary, physical, biochemical viewpoints needed. Careful consideration impact accumulation, losses, comorbidities, medications needs explored individual child before considered. When supplementing, care taken not over-prescribe. Research recommendations suggested.