Nutritio n in Children with Chron ic Ki dne y Dise ase

1 Nutrition in Children with Chronic Kidney Disease Introduction health care team may recommend a E Treatment Methods for very child needs good nutrition. change in your child's diet to protect If your child has been diagnosed the kidneys. Health problems from with kidney disease, learning CKD can be prevented or delayed by about nutrition is vital because your Kidney Failure in Children child's diet can affect how well the kid- neys work. Always consult with your eating the right foods. Kidney disease can limit a child's growth. Your child's health care team child's health care teamidneys any major changes in your Our kidneys do many things remove to help wastes K.

2 Playmaking before an important part in They will a child's growth and health. child's diet. work Problems Specific to Children with you to make sure that Everyone who has kidney failure, adults your child's growth is as normal as pos- sible. As Children and extra water from grow, their ical complications, and Children alike, will experience med- whichnutritional may include maintain our keep the body blood needs change extremeas well. Work fatigue, with inability to your concen- working properly, the kidneys remove trate, weak bones, nerve child's health care team to be certain damage, regulate blood pressure wastes and extra water from the blood. your childdepression, and sleep problems.

3 Addi- gets the right amount of all balance chemicals like sodium and tional problems for Children can include They balance the salts made of sodium, necessary nutrients. At different times, potassium potassium, calcium, and phosphorus the team may suggest changes in both make a hormone that signals bonethe amount and the types of food your that circulate in the blood. And they marrow to make red blood cells control the release of natural chemicals child needs to eat. Learning about food called hormones that make helpa hormone make red to help boneschoices grow will help you understand what and keep them strong blood cells, control blood pressure, changes need to be made to ensure that Kidney and keep bones strong.

4 Failure can lead directly to morechild is as healthy as possible. your health problems, like swelling of the In the early stagesbody, of chronic kidney and growth fail- bone deformities, Kidneys ure. A successful disease (CKD), the kidneys continue to kidney Energy transplant can give a child with chronic kidney failure Everyone needs energy to grow and work. They just don't do their job as the best chance to grow normally and well as normal kidneys do. active lead a full, Sincelife. theDialysis can behelp active. We measure the amount of Ureters decline in kidney afunction happens child to survive slow-episodeenergy an acute of in the diet by counting calories.

5 Ly, your child's body may kidney adapt, failure and or to stayyou Taking healthy until a in too little energy can lead to may not notice any donated change kidney becomes in the way available. decreased activity, poor growth, and your child looks or feels. caring Families Unfortunately, decreased resistance to infection. As for a child with kidney disease often over time, small changes can need buildhelp not up, justyour from child grows, energy needs change Bladder doctors and nurses, and as the kidney disease worsens (CKD but from a whole depending on age, height, and weight. team of pediatric specialists, including stages 4 and 5), your child may develop dietitians, social workers, and family Work with the health care team to more symptoms ofcounselors.

6 Kidney disease. determine your child's daily calorie Learning about treatments for kidney disease and getting to needs. know If your child is not growing as As kidney diseasetheprogresses, nutritional entire team can make life easier The kidneys remove wastes and extra water from the foras possible, well blood to formyour urine. child's Urine flowshealth care to from the kidneys needs change as well. When your child andthe yourkid- entire family. the bladder through the ureters. team can provide appropriate ways to neys don't work normally, your child's add calories to your child's diet. National Institute of Diabetes Nationaland Digestive Institute and and of Diabetes Kidney Diseases Digestive and Kidney Diseases Department of Health Department of Health NATIONAL INSTITUTES OF HEALTH.

7 NATIONAL INSTITUTES OF HEALTH and Human Services and Human Services Phone: Health care professionals calculate a child's Protein daily energy needs using the child's weight as Protein is an essential part of any diet. It helps part of the equation. For example, a 3-month- build and maintain muscle, bone, skin, organs, old baby requires 49 calories a day for each and blood. Some proteins help fight disease pound of her body weight. If the baby weighs and heal wounds. All proteins break down 8 pounds, she would need 392 calories per day. into waste products that must be cleaned from 8 49 = 392 the blood by the kidneys. As the baby gains weight, she requires more Doctors sometimes recommend that patients calories.

8 If she gains 2 pounds, her daily with CKD eat moderate or reduced amounts calorie requirement would increase to 490. of protein. In some patients, however, restricting protein can prevent adequate 10 49 = 490. growth and may lead to malnutrition. For The following chart shows how energy needs Children with kidney disease, the goal is to eat change as a child grows. A growing child enough protein for growth but to stay away requires more and more energy, or calories. from high protein intake. If your child is But the older child does not need as many on dialysis, your child's protein needs will calories per pound of body weight as an increase, but the amount of this increase will infant needs.

9 Be based on the type and frequency of dialysis. Talk with your child's health care team about Energy Needs for Children with the amount of protein and the sources of pro- tein in your child's diet. Animal sources such Kidney Disease as eggs, milk, cheese, chicken, fish, and red Age Range Calories / Pound / Day meats contain more of the essential amino Infant 0 6 months 49 acids the body needs. A well-balanced vege- 7 12 months 45 tarian meal plan can also provide these nutri- Toddler 1 3 years 46 ents. Your child's health care team can suggest Child 4 6 years 41 ways to make adjustments in eating habits 7 10 years 32 to help meet your child's protein needs.

10 The following table has examples of the protein Adolescents Girls Boys content of some common foods, but your 11 14 years 21 25. child's health care team can customize the 15 18 years 18 20 list to your family's diet habits. Energy needs will vary and you should discuss any changing needs with your child's health care team. 2. Protein Content of Foods Protein Needs for Children Food Serving Size with Kidney Disease Turkey breast 41 grams/cup Grams / Pound / Day Large hamburger with 34 grams/8-oz sandwich vegetables and condiments Pre- Hemo- Peritoneal Age Range Dialysis dialysis Dialysis Tuna sub 30 grams/6-inch sub Infant 0 6 months 1 Cottage cheese 26 grams/cup 7 12 months Chili con carne 24 grams/cup Toddler 1 3 years Cold-cut sub 21 grams/6-inch sub Child 4 6 years Fast food taco 20 grams/6-oz taco 7 10 years Fish sandwich with tartar sauce 20 sandwich and cheese Adolescents 11 14 years 15 18 years Girls Boys Baked beans 17 grams/cup Chicken nuggets 16 grams/6