Dietary Adherence in Children With Chronic Kidney Disease: A Review of the Evidence

Apostolou, Aggeliki; Karagiozoglou-Lampoudi, Tauhomai

doi:10.1111/jorc.12069

Cited by 11 publications

(11 citation statements)

References 44 publications

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“…A physical assessment of muscle wasting can predict the longer length of stays independently of anthropometrics or other nutritionally-related risk factors of malnutrition in hospitalized children [39]. MUAC has been revitalized in the pediatric malnutrition literature and may hold promise to aid the assessment of malnutrition [32,40,41]; it is a quick and easy anthropometric tool, especially when weight and height measurements are not available in immobilized patients [42]. Interestingly, MUAC has been reported to be less affected by fluid status changes than weight, especially in the setting of hypovolemia [43,44].…”

Section: Clinical Practice Recommendations and Rationalementioning

confidence: 99%

Nutritional management of children with acute kidney injury—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

et al. 2023

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The nutritional management of children with acute kidney injury (AKI) is complex. The dynamic nature of AKI necessitates frequent nutritional assessments and adjustments in management. Dietitians providing medical nutrition therapies to this patient population must consider the interaction of medical treatments and AKI status to effectively support both the nutrition status of patients with AKI as well as limit adverse metabolic derangements associated with inappropriately prescribed nutrition support. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPR) for the nutritional management of children with AKI. We address the need for intensive collaboration between dietitians and physicians so that nutritional management is optimized in line with AKI medical treatments. We focus on key challenges faced by dietitians regarding nutrition assessment. Furthermore, we address how nutrition support should be provided to children with AKI while taking into account the effect of various medical treatment modalities of AKI on nutritional needs. 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. Research recommendations are provided. CPRs will be regularly audited and updated by the PRNT.

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Section: Clinical Practice Recommendations and Rationalementioning

confidence: 99%

Nutritional management of children with acute kidney injury—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

et al. 2023

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“…[17][18][19] However, the first-line therapy for HTN in children with CKD is RAAS-acting agents. Children receiving RAAS-acting agents had better BP control than those receiving other classes of anti-HTN medication.…”

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confidence: 99%

Hypertension in pediatric patients with chronic kidney disease: management challenges

Gallibois¹,

Jawa²,

Noone³

2017

IJNRD

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Abstract:In contrast to adults where hypertension is a leading cause of chronic kidney disease, in pediatrics, hypertension is predominantly a sequela, however, an important one that, like in adults, is likely associated with a more rapid decline in kidney function or progression of chronic kidney disease to end stage. There is a significant issue with unrecognized, or masked, hypertension in childhood chronic kidney disease. Recent evidence and, therefore, guidelines now suggest targeting a blood pressure of <50th percentile for age, sex, and height in children with proteinuria and chronic kidney disease. This often cannot be achieved by monotherapy and additional agents need to be added. Blockade of the renin angiotensin aldosterone system represents the mainstay of therapy, although often limited by the side effect of hyperkalemia. The addition of a diuretic, at least in the earlier stages of chronic kidney disease, might help mitigate this problem.

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“…Apostolou et al ( 24 ) evaluated PhA as percentiles. They measured 400 children aged 2–18 years with BIA and classified the PhA values as percentiles derived from studies in the national pediatric population.…”

Section: Resultsmentioning

confidence: 99%

Association between phase angle and the nutritional status in pediatric populations: a systematic review

Franco-Oliva,

Ávila-Nava,

Rodríguez-Aguilar

et al. 2023

Front. Nutr.

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Background and aimsMalnutrition is prevalent in pediatric populations with any disease, and it is also related to changes in body composition. In addition, recent studies have documented relationships between these changes and phase angle (PhA), an important parameter of functional nutritional assessment. PhA could be a new marker of nutritional status. Many studies have generated information about the association between PhA and malnutrition in various pathologies, although the vast majority of this information is from adult populations. In this systematic review, we answered the following question: What is the association between PhA and the nutritional status in pediatric populations?MethodsWe performed a systematic search of the Medline/PubMed and Latin American and Caribbean Health Sciences Literature databases (LILACS) databases for studies published up to October 2022. The inclusion criteria were pediatric subjects, which reported the relationship between PhA and the nutritional status with any objective nutritional indicator, and PhA was measured by electric impedance and reported at 50 kHz. We synthesized data from the studies that reported cutoff analysis of PhA with receiver operating characteristic (ROC) curves, mean PhA values presented by nutritional status strata, and correlations between PhA and nutritional status indicators. We assessed the risk of bias by using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Quality Assessment for Diagnostic Accuracy Studies.ResultsOf the 126 studies we identified, 15 met the inclusion criteria. The included studies reported the association between PhA and objective indicators of nutritional status, including weight-for-age z-score (WAZ) <-1 standard deviation (SD) for malnutrition, height-for-age z-score (HAZ) for malnutrition-stunting, body mass index (BMI) for the starvation state, body mass index z-score (BMIz) and BMI for malnutrition, mid-upper arm circumference (MUAC) <11 cm for severe acute malnutrition (SAM), and fat-free mass index z-score (FFMIz) <-2 z-score for moderate malnutrition, among others. The report of these associations between PhA and nutritional status was based on cutoff points generated with ROC curve analysis or comparison of mean PhA values, which were reported stratified by the presence or absence of malnutrition, and correlations between PhA and anthropometric indicators for the evaluation of the nutritional status in the pediatric population. It was difficult to compare the studies due to the heterogeneity of the bioelectrical impedance analysis models used, how PhA was reported (standardized, percentiles, or degrees), and the anthropometric indicators used to diagnose malnutrition.ConclusionThe early identification of malnutrition is relevant to establish the correct nutritional treatment; PhA appears to be a sensitive indicator of nutritional status and is easy to obtain. Although the results of this review are inadequate to establish PhA cutoff points associated with malnutrition in pediatric populations, in most of the studies, there was an association between PhA and objective indicators of nutritional status.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022362413, identifier: PROSPERO 2022 CRD42022362413.

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Dietary Adherence in Children With Chronic Kidney Disease: A Review of the Evidence

Abstract: Although dietary surveys, biochemical index assessment and clinician ratings have been found not to be efficient when used as a single tool, they should be used in combination in order to give the opportunity to the health providers to perceive adherence from as many angles as possible.

Cited by 11 publications

References 44 publications

Nutritional management of children with acute kidney injury—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

Nutritional management of children with acute kidney injury—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

Hypertension in pediatric patients with chronic kidney disease: management challenges

Association between phase angle and the nutritional status in pediatric populations: a systematic review

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