TY - JOUR
T1 - The dietary management of potassium in children with CKD stages 2–5 and on dialysis—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce
AU - Desloovere, An
AU - Renken-Terhaerdt, José
AU - Tuokkola, Jetta
AU - Shaw, Vanessa
AU - Greenbaum, Larry A.
AU - Haffner, Dieter
AU - Anderson, Caroline
AU - Nelms, Christina L.
AU - Oosterveld, Michiel J. S.
AU - Paglialonga, Fabio
AU - Polderman, Nonnie
AU - Qizalbash, Leila
AU - Warady, Bradley A.
AU - Shroff, Rukshana
AU - Vande Walle, Johan
N1 - Funding Information: Vitaflo International Ltd is a nutrition company which produces specialized clinical nutrition products for metabolic disorders, nutrition support, and specific conditions such as kidney disease. Vitaflo International Ltd has funded the meetings held by the Pediatric Renal Nutrition Taskforce. The Pediatric Renal Nutrition Taskforce wish to confirm that Vitaflo has not influenced the development or content of these Clinical Practice Recommendations. RS is funded by a National Institute for Health Research (NIHR) CDF-2016-09-038 Career Development Fellowship. This publication presents independent research funded by the NIHR. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. We thank Molly Vega, Pediatric Renal Dietitian, for reviewing the paper. Participants in the Delphi survey: Dietitians: Cader S, Cape Town, South Africa; Cavanagh R, Melbourne, Australia; Ezzat M, Riyadh, Saudi Arabia; Ferreira-Ring L, Hamburg, Germany; Friedlander S, Auckland, New Zealand; H?rmann P, Marburg, Germany; Janes S, Birmingham, UK; Juarez-Calderon M, Houston, USA; Kolbensvik J, Oklahoma City, USA; Laureti F, Rome, Italy; Levitt R, San Diego, USA; Liebstein D, New York, USA; Marino D, Rome, Italy; Matilda A, Bangalore, India; Muniz D, Randwick, Australia; Murphy M, Lexington, USA; McMaster M, Edmonton, Canada; Nowogorska I, Gdansk, Poland; Pedarsani P, Los Angeles, USA; Sgambat K, Washington D.C., USA; Shaik A, New Delhi, India; Trimmel-Schwahofer P, Vienna, Austria; Van Roye L, De Haan, Belgium; Venrooij L, Rotterdam, Netherlands; Winderlich J, Melbourne, Australia; Yeung C, Hong Kong; Zwolsman M, Groningen, Netherlands. Pediatric nephrologists: Arbeiter K, Vienna, Austria; Ariceta G, Barcelona, Spain; Bakkaloglu S, Ankara, Turkey; Bayazit AK, Adana, Turkey; Besouw M, Groningen, Netherlands; Govindan S, Chennai, India; Ha I, Seoul, South Korea; Hamasaki Y, Tokyo, Japan; Hashimoto J, Tokyo, Japan; Iyengar A, Bangalore, India; Jobsis J, Amsterdam, Netherlands; Johnstone L, Melbourne, Australia; Kang HG, Seoul, South Korea; Kiessling S, Lexington, USA; Klaus G, Marburg, Germany; Koch V, Sao Paulo, Brazil; Krischock L, Sydney, Australia; Kupferman J, Brooklyn, USA; Lalayiannis A, Birmingham, UK; Lane P, Oklahoma City, USA; Ma A, Hong Kong; Moritz M, Pittsburgh, USA; Moudgil A, Washington D.C., USA; McCulloch M, Cape Town, South Africa; Oh J, Hamburg, Germany; Prestige C, Auckland, New Zealand; Prytula A, Ghent, Belgium; Puliyanda D, Los Angeles, USA; Quinlan C, Melbourne, Australia; Reusz G, Budapest, Hungary; Saha A, New Delhi, India; Sever L, Istanbul, Turkey; Sharma J, Pune, India; Swartz S, Houston, USA; Singhal J, Pune, India; Verrina E, Genova, Italy; Vidal E, Udine, Italy; Xu H, Shanghai, China; Zagozdzon I, Gdansk, Poland. Funding Information: RS is funded by a National Institute for Health Research (NIHR) CDF-2016-09-038 Career Development Fellowship. This publication presents independent research funded by the NIHR. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - Dyskalemias are often seen in children with chronic kidney disease (CKD). While hyperkalemia is common, with an increasing prevalence as glomerular filtration rate declines, hypokalemia may also occur, particularly in children with renal tubular disorders and those on intensive dialysis regimens. Dietary assessment and adjustment of potassium intake is critically important in children with CKD as hyperkalemia can be life-threatening. Manipulation of dietary potassium can be challenging as it may affect the intake of other nutrients and reduce palatability. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) for the dietary management of potassium in children with CKD stages 2–5 and on dialysis (CKD2–5D). We describe the assessment of dietary potassium intake, requirements for potassium in healthy children, and the dietary management of hypo- and hyperkalemia in children with CKD2–5D. Common potassium containing foods are described and approaches to adjusting potassium intake that can be incorporated into everyday practice discussed. Given the poor quality of evidence available, a Delphi survey was conducted to seek consensus from international experts. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs, based on the clinical judgment of the treating physician and dietitian. These CPRs will be regularly audited and updated by the PRNT.
AB - Dyskalemias are often seen in children with chronic kidney disease (CKD). While hyperkalemia is common, with an increasing prevalence as glomerular filtration rate declines, hypokalemia may also occur, particularly in children with renal tubular disorders and those on intensive dialysis regimens. Dietary assessment and adjustment of potassium intake is critically important in children with CKD as hyperkalemia can be life-threatening. Manipulation of dietary potassium can be challenging as it may affect the intake of other nutrients and reduce palatability. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) for the dietary management of potassium in children with CKD stages 2–5 and on dialysis (CKD2–5D). We describe the assessment of dietary potassium intake, requirements for potassium in healthy children, and the dietary management of hypo- and hyperkalemia in children with CKD2–5D. Common potassium containing foods are described and approaches to adjusting potassium intake that can be incorporated into everyday practice discussed. Given the poor quality of evidence available, a Delphi survey was conducted to seek consensus from international experts. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs, based on the clinical judgment of the treating physician and dietitian. These CPRs will be regularly audited and updated by the PRNT.
KW - Children
KW - Chronic kidney disease
KW - Clinical Practice Recommendations (CPRs)
KW - Dialysis
KW - Dietary intake
KW - Pediatric Renal Nutrition Taskforce (PRNT)
KW - Potassium
UR - http://www.scopus.com/inward/record.url?scp=85102917118&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00467-021-04923-1
DO - https://doi.org/10.1007/s00467-021-04923-1
M3 - Review article
C2 - 33730284
SN - 0931-041X
VL - 36
SP - 1331
EP - 1346
JO - Pediatric nephrology (Berlin, Germany)
JF - Pediatric nephrology (Berlin, Germany)
IS - 6
ER -