The nutritional approach for pediatric patients undergoing CAPD/CCPD.
The current recommendations for the nutritional management of children treated with CAPD/CCPD will be reviewed. The optimal caloric intake for pre-pubertal children undergoing dialysis should at least be determined by the recommended daily allowances (RDA) of the National Academy of Science for healthy children of the same height and age. For pubertal and post-pubertal patients, the prescribed energy intake is similar to the RDA for adolescents, 60 kcal/kg for males, and 48 kcal/kg/day for females. Dietary complex carbohydrates should provide about 35% of dietary energy intake. Dietary fat should provide 50% of the dietary intake, and the PS:S fatty ratio should be about 1.5:1.0. The recommended protein intake for children less than 3 years of age should range between 2.5-3.0 gm/kg/day; for children between 3 years of age and puberty 2.5 gm/kg/day; for pubertal patients 2.0 gm/kg/day, and post-pubertal patients 1.5 gm/kg/day. In general, sodium, potassium and water intake vary markedly among patients and should be managed individually. Vitamins, folic acid 1 mg/day; peridoxine, B6 5-10 mg/day; and ascorbic acid 75-100 mg/day. Vitamin D sterols (i.e., calcitriol) and phosphate binding agents mainly calcium carbonate are needed for the prevention and control of renal bone disease in such patients. Aluminum containing gels should be avoided in order to prevent aluminum accumulation secondary to the ingestion of aluminum containing gels.
Salusky
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IB
Department of Pediatrics, UCLA School of Medicine.
D002648:Child; D002675:Child, Preschool; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000517:prevention & control; D004035:Diet Therapy; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D009751:Nutritional Requirements; D010530:Peritoneal Dialysis / Q000379:methods*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D014815:Vitamins / Q000627:therapeutic use
D004041:Dietary Fats; D004044:Dietary Proteins; D014815:Vitamins