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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

(2024) PEDIATRIC NEPHROLOGY. 39(10). p.3103-3124
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Organization
Abstract
Children with chronic kidney disease (CKD) are at risk for vitamin deficiency or excess. Vitamin status can be affected by diet, supplements, kidney function, medications, and dialysis. Little is known about vitamin requirements in CKD, leading to practice variation.The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric kidney dietitians and pediatric nephrologists, was established to develop evidence-based clinical practice points (CPPs) to address challenges and to serve as a resource for nutritional care. Questions were formulated using PICO (Patient, Intervention, Comparator, Outcomes), and literature searches undertaken to explore clinical practice from assessment to management of vitamin status in children with CKD stages 2-5, on dialysis and post-transplantation (CKD2-5D&T). The CPPs were developed and finalized using a Delphi consensus approach. We present six CPPs for vitamin management for children with CKD2-5D&T. We address assessment, intervention, and monitoring. We recommend avoiding supplementation of vitamin A and suggest water-soluble vitamin supplementation for those on dialysis. In the absence of evidence, a consistent structured approach to vitamin management that considers assessment and monitoring from dietary, physical, and biochemical viewpoints is needed. Careful consideration of the impact of accumulation, losses, comorbidities, and medications needs to be explored for the individual child and vitamin before supplementation can be considered. When supplementing, care needs to be taken not to over-prescribe. Research recommendations are suggested.
Keywords
Nephrology, Pediatrics, Perinatology and Child Health, Children, Clinical practice points, Pediatric Renal Nutrition Taskforce, Chronic kidney disease, Vitamins

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MLA
Anderson, Caroline E., et al. “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.” PEDIATRIC NEPHROLOGY, vol. 39, no. 10, 2024, pp. 3103–24, doi:10.1007/s00467-024-06303-x.
APA
Anderson, C. E., Tuokkola, J., Qizalbash, L., Harmer, M., Nelms, C. L., Stabouli, S., … Warady, B. A. (2024). 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. PEDIATRIC NEPHROLOGY, 39(10), 3103–3124. https://doi.org/10.1007/s00467-024-06303-x
Chicago author-date
Anderson, Caroline E., Jetta Tuokkola, Leila Qizalbash, Matthew Harmer, Christina L. Nelms, Stella Stabouli, Barry Toole, et al. 2024. “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.” PEDIATRIC NEPHROLOGY 39 (10): 3103–24. https://doi.org/10.1007/s00467-024-06303-x.
Chicago author-date (all authors)
Anderson, Caroline E., Jetta Tuokkola, Leila Qizalbash, Matthew Harmer, Christina L. Nelms, Stella Stabouli, Barry Toole, Nonnie Polderman, An Desloovere, Jose Renken-Terhaerdt, Molly R. Wong Vega, Evelien Snauwaert, Johan Vande Walle, Dieter Haffner, Fabio Paglialonga, Rukshana Shroff, Vanessa Shaw, Larry A. Greenbaum, and Bradley A. Warady. 2024. “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.” PEDIATRIC NEPHROLOGY 39 (10): 3103–3124. doi:10.1007/s00467-024-06303-x.
Vancouver
1.
Anderson CE, Tuokkola J, Qizalbash L, Harmer M, Nelms CL, Stabouli S, et al. 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. PEDIATRIC NEPHROLOGY. 2024;39(10):3103–24.
IEEE
[1]
C. E. Anderson et al., “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,” PEDIATRIC NEPHROLOGY, vol. 39, no. 10, pp. 3103–3124, 2024.
@article{01HV6G7P7FTRGXMRVE3GN10FAY,
  abstract     = {{Children with chronic kidney disease (CKD) are at risk for vitamin deficiency or excess. Vitamin status can be affected by diet, supplements, kidney function, medications, and dialysis. Little is known about vitamin requirements in CKD, leading to practice variation.The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric kidney dietitians and pediatric nephrologists, was established to develop evidence-based clinical practice points (CPPs) to address challenges and to serve as a resource for nutritional care. Questions were formulated using PICO (Patient, Intervention, Comparator, Outcomes), and literature searches undertaken to explore clinical practice from assessment to management of vitamin status in children with CKD stages 2-5, on dialysis and post-transplantation (CKD2-5D&T). The CPPs were developed and finalized using a Delphi consensus approach. We present six CPPs for vitamin management for children with CKD2-5D&T. We address assessment, intervention, and monitoring. We recommend avoiding supplementation of vitamin A and suggest water-soluble vitamin supplementation for those on dialysis. In the absence of evidence, a consistent structured approach to vitamin management that considers assessment and monitoring from dietary, physical, and biochemical viewpoints is needed. Careful consideration of the impact of accumulation, losses, comorbidities, and medications needs to be explored for the individual child and vitamin before supplementation can be considered. When supplementing, care needs to be taken not to over-prescribe. Research recommendations are suggested.}},
  author       = {{Anderson, Caroline E. and Tuokkola, Jetta and Qizalbash, Leila and Harmer, Matthew and Nelms, Christina L. and Stabouli, Stella and Toole, Barry and Polderman, Nonnie and Desloovere, An and Renken-Terhaerdt, Jose and Vega, Molly R. Wong and Snauwaert, Evelien and Vande Walle, Johan and Haffner, Dieter and Paglialonga, Fabio and Shroff, Rukshana and Shaw, Vanessa and Greenbaum, Larry A. and Warady, Bradley A.}},
  issn         = {{0931-041X}},
  journal      = {{PEDIATRIC NEPHROLOGY}},
  keywords     = {{Nephrology,Pediatrics, Perinatology and Child Health,Children,Clinical practice points,Pediatric Renal Nutrition Taskforce,Chronic kidney disease,Vitamins}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{3103--3124}},
  title        = {{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}},
  url          = {{http://doi.org/10.1007/s00467-024-06303-x}},
  volume       = {{39}},
  year         = {{2024}},
}

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