Assessment and management of magnesium and trace element status in children with CKD stages 2–5, on dialysis and post-transplantation : clinical practice points from the Pediatric Renal Nutrition Taskforce
- Author
- Jetta Tuokkola, Caroline E. Anderson, Sheridan Collins, Pearl Pugh, Molly R. Wong Vega, Matthew Harmer, Lyndsay A. Harshman, Christina L. Nelms, Barry Toole, An Desloovere (UGent) , Fabio Paglialonga, Nonnie Polderman, José Renken-Terhaerdt, Rukshana Shroff (UGent) , Evelien Snauwaert (UGent) , Stella Stabouli, Johan Vande Walle (UGent) , Bradley A. Warady, Vanessa Shaw and Larry A. Greenbaum
- Organization
- Abstract
- Children and young people with chronic kidney disease (CKD) are at risk for deficiency or excess of magnesium and trace elements. Kidney function, dialysis, medication, and dietary and supplemental intake can affect their biochemical status. There is much uncertainty about the requirements of magnesium and trace elements in CKD, which leads to variation in practice. The Pediatric Renal Nutrition Taskforce is an international team of pediatric kidney dietitians and pediatric nephrologists, formed to develop evidence-based clinical practice points to improve the nutritional care of children with CKD. PICO (patient, intervention, comparator, and outcomes) questions led the literature searches, which were conducted to ascertain current biochemical status, dietary intake, and factors leading to requirements differing from healthy peers, and to guide nutritional care of children with CKD stages 2-5, on dialysis, and post-transplantation. We address the assessment and intervention of magnesium and the trace elements chromium, copper, fluoride, iodine, manganese, selenium, and zinc. We suggest routine biochemical assessment of magnesium. Trace element assessment is based on clinical suspicion of deficiency or excess and their risk factors, including accumulation, losses, medications, nutrient interactions, and comorbidities. In particular, we suggest assessing magnesium, copper, iodine, and zinc when growth is poor, and evaluating magnesium, copper, selenium, and zinc in the presence of proteinuria. A structured approach to magnesium and trace element management, including biochemical, physical, and dietary assessment, is beneficial in the paucity of evidence. Research recommendations are suggested.
- Keywords
- Magnesium, Minerals, Trace elements, Chronic kidney disease, Pediatric Renal Nutrition Taskforce, Clinical practice points, Children, SODIUM POLYSTYRENE SULFONATE, CHRONIC KIDNEY-DISEASE, REVERSIBLE PRIMARY HYPOTHYROIDISM, IODINE-INDUCED HYPOTHYROIDISM, SERUM ZINC CONCENTRATIONS, PITUITARY-THYROID AXIS, HEMODIALYSIS-PATIENTS, TRANSPLANT RECIPIENTS, ANTIOXIDANT ENZYMES, PERITONEAL-DIALYSIS
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-01JXD9XWR9DDRPE9SFYSRWRT9P
- MLA
- Tuokkola, Jetta, et al. “Assessment and Management of Magnesium and Trace Element 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. 40, no. 10, 2025, pp. 3301–23, doi:10.1007/s00467-025-06759-5.
- APA
- Tuokkola, J., Anderson, C. E., Collins, S., Pugh, P., Vega, M. R. W., Harmer, M., … Greenbaum, L. A. (2025). Assessment and management of magnesium and trace element status in children with CKD stages 2–5, on dialysis and post-transplantation : clinical practice points from the Pediatric Renal Nutrition Taskforce. PEDIATRIC NEPHROLOGY, 40(10), 3301–3323. https://doi.org/10.1007/s00467-025-06759-5
- Chicago author-date
- Tuokkola, Jetta, Caroline E. Anderson, Sheridan Collins, Pearl Pugh, Molly R. Wong Vega, Matthew Harmer, Lyndsay A. Harshman, et al. 2025. “Assessment and Management of Magnesium and Trace Element Status in Children with CKD Stages 2–5, on Dialysis and Post-Transplantation : Clinical Practice Points from the Pediatric Renal Nutrition Taskforce.” PEDIATRIC NEPHROLOGY 40 (10): 3301–23. https://doi.org/10.1007/s00467-025-06759-5.
- Chicago author-date (all authors)
- Tuokkola, Jetta, Caroline E. Anderson, Sheridan Collins, Pearl Pugh, Molly R. Wong Vega, Matthew Harmer, Lyndsay A. Harshman, Christina L. Nelms, Barry Toole, An Desloovere, Fabio Paglialonga, Nonnie Polderman, José Renken-Terhaerdt, Rukshana Shroff, Evelien Snauwaert, Stella Stabouli, Johan Vande Walle, Bradley A. Warady, Vanessa Shaw, and Larry A. Greenbaum. 2025. “Assessment and Management of Magnesium and Trace Element Status in Children with CKD Stages 2–5, on Dialysis and Post-Transplantation : Clinical Practice Points from the Pediatric Renal Nutrition Taskforce.” PEDIATRIC NEPHROLOGY 40 (10): 3301–3323. doi:10.1007/s00467-025-06759-5.
- Vancouver
- 1.Tuokkola J, Anderson CE, Collins S, Pugh P, Vega MRW, Harmer M, et al. Assessment and management of magnesium and trace element status in children with CKD stages 2–5, on dialysis and post-transplantation : clinical practice points from the Pediatric Renal Nutrition Taskforce. PEDIATRIC NEPHROLOGY. 2025;40(10):3301–23.
- IEEE
- [1]J. Tuokkola et al., “Assessment and management of magnesium and trace element 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. 40, no. 10, pp. 3301–3323, 2025.
@article{01JXD9XWR9DDRPE9SFYSRWRT9P,
abstract = {{Children and young people with chronic kidney disease (CKD) are at risk for deficiency or excess of magnesium and trace elements. Kidney function, dialysis, medication, and dietary and supplemental intake can affect their biochemical status. There is much uncertainty about the requirements of magnesium and trace elements in CKD, which leads to variation in practice. The Pediatric Renal Nutrition Taskforce is an international team of pediatric kidney dietitians and pediatric nephrologists, formed to develop evidence-based clinical practice points to improve the nutritional care of children with CKD. PICO (patient, intervention, comparator, and outcomes) questions led the literature searches, which were conducted to ascertain current biochemical status, dietary intake, and factors leading to requirements differing from healthy peers, and to guide nutritional care of children with CKD stages 2-5, on dialysis, and post-transplantation. We address the assessment and intervention of magnesium and the trace elements chromium, copper, fluoride, iodine, manganese, selenium, and zinc. We suggest routine biochemical assessment of magnesium. Trace element assessment is based on clinical suspicion of deficiency or excess and their risk factors, including accumulation, losses, medications, nutrient interactions, and comorbidities. In particular, we suggest assessing magnesium, copper, iodine, and zinc when growth is poor, and evaluating magnesium, copper, selenium, and zinc in the presence of proteinuria. A structured approach to magnesium and trace element management, including biochemical, physical, and dietary assessment, is beneficial in the paucity of evidence. Research recommendations are suggested.}},
author = {{Tuokkola, Jetta and Anderson, Caroline E. and Collins, Sheridan and Pugh, Pearl and Vega, Molly R. Wong and Harmer, Matthew and Harshman, Lyndsay A. and Nelms, Christina L. and Toole, Barry and Desloovere, An and Paglialonga, Fabio and Polderman, Nonnie and Renken-Terhaerdt, José and Shroff, Rukshana and Snauwaert, Evelien and Stabouli, Stella and Vande Walle, Johan and Warady, Bradley A. and Shaw, Vanessa and Greenbaum, Larry A.}},
issn = {{0931-041X}},
journal = {{PEDIATRIC NEPHROLOGY}},
keywords = {{Magnesium,Minerals,Trace elements,Chronic kidney disease,Pediatric Renal Nutrition Taskforce,Clinical practice points,Children,SODIUM POLYSTYRENE SULFONATE,CHRONIC KIDNEY-DISEASE,REVERSIBLE PRIMARY HYPOTHYROIDISM,IODINE-INDUCED HYPOTHYROIDISM,SERUM ZINC CONCENTRATIONS,PITUITARY-THYROID AXIS,HEMODIALYSIS-PATIENTS,TRANSPLANT RECIPIENTS,ANTIOXIDANT ENZYMES,PERITONEAL-DIALYSIS}},
language = {{eng}},
number = {{10}},
pages = {{3301--3323}},
title = {{Assessment and management of magnesium and trace element 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/s00467-025-06759-5}},
volume = {{40}},
year = {{2025}},
}
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