KDOQI Updates Pediatric Nutrition Guideline

NEW YORK, NEW YORK (March 2, 2008) — The National Kidney Foundation’s KDOQI Clinical Practice Guideline for Nutrition in Children with CKD: 2008, published today as a supplement to the American Journal of Kidney Diseases, addresses a critical need in a growing population. The guideline updates and expands the pediatric recommendations of the 2000 Kidney Disease Outcomes Quality Initiative (KDOQIâ„¢) Clinical Practice Guidelines for Nutrition in Chronic Renal Failure.

Among the revisions from the previous guideline are recommendations concerning the dietary intake of sodium, potassium, calcium, phosphorus, and fat in children with CKD. The update also provides new information on the diagnosis and management of nutritional issues in children with CKD and new benchmarks for evaluating growth.

“A review of the literature published in the last eight years found substantial new evidence concerning the evaluation and management of nutritional parameters in children,” says KDOQI Chair Michael Rocco, MD, MSCE. “The effect of nutrition is especially important in children because of its impact on growth and development,” Dr. Rocco continues.

According to Donna Secker, PhD, RD, one of the two co-chairs of the work group, “The guideline offers recommendations for evaluating nutritional status and growth and providing nutritional counseling and management, including therapeutic interventions such as enteral (tube) feeding, intradialytic parenteral nutrition, growth hormone therapy, and restriction or supplementation of various macro- and micronutrients. It also provides a wealth of reference material to help with implementation, including new growth charts from the World Health Organization, tables of food and formula nutrient content, and a list of available electronic tools for quick calculation of energy requirements, midparental height and anthropometric z scores,”

Key topics included in the guideline:
  • Evaluation of Growth and Nutritional Status
  • Requirements and Therapy
  • Growth
  • Bone and Mineral and Vitamin D Requirements and Therapy
  • Nutrition Management and Counseling
  • Fluid and Electrolyte
  • Energy Requirements and Therapy
  • Requirements and Therapy
  • Protein Requirements and Therapy
  • Carnitine
  • Vitamin and Trace Elements
  • Nutritional Management of Transplant Patients

  • "The guideline is intended to assist the practitioner caring for infants, children and adolescents with CKD stages 2-5, on long-term dialysis or with a kidney transplant. The recommendations for nutritional management are essential to the well being of these children, and specifically emphasize the relationship between nutritional status and the risk of cardiovascular disease,” says Bradley Warady, MD, work group co-chair.

    The guideline is available online in its entirety at www.kdoqi.org.

    Guideline Work Group
    This NKF- KDOQI guideline is the result of two years’ of work reviewing evidence published in peer-reviewed medical journals by eight volunteer experts in nephrology, pediatrics, nutrition, nursing. The guideline is a product of rigorous peer review process.

    About the National Kidney Foundation
    The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases, influencing public policy in support of the kidney community and increasing the availability of all organs for transplantation.

    About KDOQI
    KDOQI expands the Dialysis Outcomes Quality Initiative or DOQI, a project begun by the National Kidney Foundation in 1995 and recognized throughout the world for improving the care of dialysis patients. For more information, please visit www.kdoqi.org or call (800) 622-9010.