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The dietary management of potassium in children with CKD stages 2–5 and on dialysis : clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

(2021) PEDIATRIC NEPHROLOGY. 36(6). p.1331-1346
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Abstract
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.
Keywords
Nephrology, Pediatrics, Perinatology and Child Health, Potassium, Dietary intake, Chronic kidney disease, Dialysis, Children, Clinical Practice Recommendations (CPRs), Pediatric Renal Nutrition Taskforce (PRNT), SODIUM POLYSTYRENE SULFONATE, CHRONIC KIDNEY-DISEASE, ZIRCONIUM CYCLOSILICATE, MINERAL-CONTENT, INFANT FORMULA, HYPERKALEMIA, PHOSPHORUS, COOKING, CALCIUM, PRETREATMENT

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Citation

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MLA
Desloovere, An, et al. “The Dietary Management of Potassium in Children with CKD Stages 2–5 and on Dialysis : Clinical Practice Recommendations from the Pediatric Renal Nutrition Taskforce.” PEDIATRIC NEPHROLOGY, vol. 36, no. 6, 2021, pp. 1331–46, doi:10.1007/s00467-021-04923-1.
APA
Desloovere, A., Renken-Terhaerdt, J., Tuokkola, J., Shaw, V., Greenbaum, L. A., Haffner, D., … Vande Walle, J. (2021). The dietary management of potassium in children with CKD stages 2–5 and on dialysis : clinical practice recommendations from the Pediatric Renal Nutrition Taskforce. PEDIATRIC NEPHROLOGY, 36(6), 1331–1346. https://doi.org/10.1007/s00467-021-04923-1
Chicago author-date
Desloovere, An, José Renken-Terhaerdt, Jetta Tuokkola, Vanessa Shaw, Larry A. Greenbaum, Dieter Haffner, Caroline Anderson, et al. 2021. “The Dietary Management of Potassium in Children with CKD Stages 2–5 and on Dialysis : Clinical Practice Recommendations from the Pediatric Renal Nutrition Taskforce.” PEDIATRIC NEPHROLOGY 36 (6): 1331–46. https://doi.org/10.1007/s00467-021-04923-1.
Chicago author-date (all authors)
Desloovere, An, José Renken-Terhaerdt, Jetta Tuokkola, Vanessa Shaw, Larry A. Greenbaum, Dieter Haffner, Caroline Anderson, Christina L. Nelms, Michiel J. S. Oosterveld, Fabio Paglialonga, Nonnie Polderman, Leila Qizalbash, Bradley A. Warady, Rukshana Shroff, and Johan Vande Walle. 2021. “The Dietary Management of Potassium in Children with CKD Stages 2–5 and on Dialysis : Clinical Practice Recommendations from the Pediatric Renal Nutrition Taskforce.” PEDIATRIC NEPHROLOGY 36 (6): 1331–1346. doi:10.1007/s00467-021-04923-1.
Vancouver
1.
Desloovere A, Renken-Terhaerdt J, Tuokkola J, Shaw V, Greenbaum LA, Haffner D, et al. The dietary management of potassium in children with CKD stages 2–5 and on dialysis : clinical practice recommendations from the Pediatric Renal Nutrition Taskforce. PEDIATRIC NEPHROLOGY. 2021;36(6):1331–46.
IEEE
[1]
A. Desloovere et al., “The dietary management of potassium in children with CKD stages 2–5 and on dialysis : clinical practice recommendations from the Pediatric Renal Nutrition Taskforce,” PEDIATRIC NEPHROLOGY, vol. 36, no. 6, pp. 1331–1346, 2021.
@article{8753849,
  abstract     = {{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.}},
  author       = {{Desloovere, An and Renken-Terhaerdt, José and Tuokkola, Jetta and Shaw, Vanessa and Greenbaum, Larry A. and Haffner, Dieter and Anderson, Caroline and Nelms, Christina L. and Oosterveld, Michiel J. S. and Paglialonga, Fabio and Polderman, Nonnie and Qizalbash, Leila and Warady, Bradley A. and Shroff, Rukshana and Vande Walle, Johan}},
  issn         = {{0931-041X}},
  journal      = {{PEDIATRIC NEPHROLOGY}},
  keywords     = {{Nephrology,Pediatrics,Perinatology and Child Health,Potassium,Dietary intake,Chronic kidney disease,Dialysis,Children,Clinical Practice Recommendations (CPRs),Pediatric Renal Nutrition Taskforce (PRNT),SODIUM POLYSTYRENE SULFONATE,CHRONIC KIDNEY-DISEASE,ZIRCONIUM CYCLOSILICATE,MINERAL-CONTENT,INFANT FORMULA,HYPERKALEMIA,PHOSPHORUS,COOKING,CALCIUM,PRETREATMENT}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1331--1346}},
  title        = {{The dietary management of potassium in children with CKD stages 2–5 and on dialysis : clinical practice recommendations from the Pediatric Renal Nutrition Taskforce}},
  url          = {{http://doi.org/10.1007/s00467-021-04923-1}},
  volume       = {{36}},
  year         = {{2021}},
}

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