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The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis : clinical practice recommendation from the Pediatric Renal Nutrition Taskforce

(2020) PEDIATRIC NEPHROLOGY. 35(3). p.501-518
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Abstract
In children with chronic kidney disease (CKD), optimal control of bone and mineral homeostasis is essential, not only for the prevention of debilitating skeletal complications and achieving adequate growth but also for preventing vascular calcification and cardiovascular disease. Complications of mineral bone disease (MBD) are common and contribute to the high morbidity and mortality seen in children with CKD. Although several studies describe the prevalence of abnormal calcium, phosphate, parathyroid hormone, and vitamin D levels as well as associated clinical and radiological complications and their medical management, little is known about the dietary requirements and management of calcium (Ca) and phosphate (P) in children with CKD. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists, who develop clinical practice recommendations (CPRs) for the nutritional management of various aspects of renal disease management in children. We present CPRs for the dietary intake of Ca and P in children with CKD stages 2-5 and on dialysis (CKD2-5D), describing the common Ca- and P-containing foods, the assessment of dietary Ca and P intake, requirements for Ca and P in healthy children and necessary modifications for children with CKD2-5D, and dietary management of hypo- and hypercalcemia and hyperphosphatemia. The statements have been graded, and 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.
Keywords
Nephrology, Pediatrics, Perinatology and Child Health, Calcium, Phosphate, Nutrition, Chronic kidney disease (CKD), Children, CHRONIC KIDNEY-DISEASE, BONE-MINERAL DENSITY, FOOD-FREQUENCY QUESTIONNAIRE, GROWTH-FACTOR 23, VITAMIN-D, VASCULAR CALCIFICATION, PHOSPHORUS INTAKE, HEALTH IMPACT, METABOLISM, CHILDHOOD

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Citation

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MLA
McAlister, Louise, et al. “The Dietary Management of Calcium and Phosphate in Children with CKD Stages 2-5 and on Dialysis : Clinical Practice Recommendation from the Pediatric Renal Nutrition Taskforce.” PEDIATRIC NEPHROLOGY, vol. 35, no. 3, 2020, pp. 501–18, doi:10.1007/s00467-019-04370-z.
APA
McAlister, L., Pugh, P., Greenbaum, L., Haffner, D., Rees, L., Anderson, C., … Shroff, R. (2020). The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis : clinical practice recommendation from the Pediatric Renal Nutrition Taskforce. PEDIATRIC NEPHROLOGY, 35(3), 501–518. https://doi.org/10.1007/s00467-019-04370-z
Chicago author-date
McAlister, Louise, Pearl Pugh, Laurence Greenbaum, Dieter Haffner, Lesley Rees, Caroline Anderson, An Desloovere, et al. 2020. “The Dietary Management of Calcium and Phosphate in Children with CKD Stages 2-5 and on Dialysis : Clinical Practice Recommendation from the Pediatric Renal Nutrition Taskforce.” PEDIATRIC NEPHROLOGY 35 (3): 501–18. https://doi.org/10.1007/s00467-019-04370-z.
Chicago author-date (all authors)
McAlister, Louise, Pearl Pugh, Laurence Greenbaum, Dieter Haffner, Lesley Rees, Caroline Anderson, An Desloovere, Christina Nelms, Michiel Oosterveld, Fabio Paglialonga, Nonnie Polderman, Leila Qizalbash, José Renken-Terhaerdt, Jetta Tuokkola, Bradley Warady, Johan Vande Walle, Vanessa Shaw, and Rukshana Shroff. 2020. “The Dietary Management of Calcium and Phosphate in Children with CKD Stages 2-5 and on Dialysis : Clinical Practice Recommendation from the Pediatric Renal Nutrition Taskforce.” PEDIATRIC NEPHROLOGY 35 (3): 501–518. doi:10.1007/s00467-019-04370-z.
Vancouver
1.
McAlister L, Pugh P, Greenbaum L, Haffner D, Rees L, Anderson C, et al. The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis : clinical practice recommendation from the Pediatric Renal Nutrition Taskforce. PEDIATRIC NEPHROLOGY. 2020;35(3):501–18.
IEEE
[1]
L. McAlister et al., “The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis : clinical practice recommendation from the Pediatric Renal Nutrition Taskforce,” PEDIATRIC NEPHROLOGY, vol. 35, no. 3, pp. 501–518, 2020.
@article{8748496,
  abstract     = {{In children with chronic kidney disease (CKD), optimal control of bone and mineral homeostasis is essential, not only for the prevention of debilitating skeletal complications and achieving adequate growth but also for preventing vascular calcification and cardiovascular disease. Complications of mineral bone disease (MBD) are common and contribute to the high morbidity and mortality seen in children with CKD. Although several studies describe the prevalence of abnormal calcium, phosphate, parathyroid hormone, and vitamin D levels as well as associated clinical and radiological complications and their medical management, little is known about the dietary requirements and management of calcium (Ca) and phosphate (P) in children with CKD. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists, who develop clinical practice recommendations (CPRs) for the nutritional management of various aspects of renal disease management in children. We present CPRs for the dietary intake of Ca and P in children with CKD stages 2-5 and on dialysis (CKD2-5D), describing the common Ca- and P-containing foods, the assessment of dietary Ca and P intake, requirements for Ca and P in healthy children and necessary modifications for children with CKD2-5D, and dietary management of hypo- and hypercalcemia and hyperphosphatemia. The statements have been graded, and 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.}},
  author       = {{McAlister, Louise and Pugh, Pearl and Greenbaum, Laurence and Haffner, Dieter and Rees, Lesley and Anderson, Caroline and Desloovere, An and Nelms, Christina and Oosterveld, Michiel and Paglialonga, Fabio and Polderman, Nonnie and Qizalbash, Leila and Renken-Terhaerdt, José and Tuokkola, Jetta and Warady, Bradley and Vande Walle, Johan and Shaw, Vanessa and Shroff, Rukshana}},
  issn         = {{0931-041X}},
  journal      = {{PEDIATRIC NEPHROLOGY}},
  keywords     = {{Nephrology,Pediatrics,Perinatology and Child Health,Calcium,Phosphate,Nutrition,Chronic kidney disease (CKD),Children,CHRONIC KIDNEY-DISEASE,BONE-MINERAL DENSITY,FOOD-FREQUENCY QUESTIONNAIRE,GROWTH-FACTOR 23,VITAMIN-D,VASCULAR CALCIFICATION,PHOSPHORUS INTAKE,HEALTH IMPACT,METABOLISM,CHILDHOOD}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{501--518}},
  title        = {{The dietary management of calcium and phosphate in children with CKD stages 2-5 and on dialysis : clinical practice recommendation from the Pediatric Renal Nutrition Taskforce}},
  url          = {{http://doi.org/10.1007/s00467-019-04370-z}},
  volume       = {{35}},
  year         = {{2020}},
}

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