Assessment of dietary intake of children with chronic kidney disease.
Our aim was to characterize the nutrient intake of children with chronic kidney disease (CKD) relative to recommended intake levels.



We conducted a cross-sectional study of dietary intake assessed by Food Frequency Questionnaire (FFQ) in The North American Chronic Kidney Disease in Children (CKiD) prospective cohort study. Nutrient intake was analyzed to estimate the daily consumption levels of various nutrients and compared with national guidelines for intake.



There were 658 FFQs available for analysis; 69.9 % of respondents were boys, with a median age [Interquartile range (IQR)] of 11 years (8-15). Median daily sodium, potassium, and phosphorus intake was 3089 mg (2294-4243), 2384 mg (1804-3076), and 1206 mg (894-1612) respectively. Sodium and phosphorus consumptions were higher than recommended in all age groups. Caloric intake decreased with dropping glomerular filtration rate (GFR) (p = 0.003). The median daily caloric intakes were 1307 kcal in male children 2-3 years old, 1875 kcal in children 4-8 years old, 1923 kcal in those 9-13 years old, and 2427 kcal in those 14-18 years old. Respective levels for girls were 1467 kcal, 1736 kcal, 1803 kcal, and 2281 kcal. Median protein intake exceeded recommended levels in all age groups, particularly among younger participants. Younger children were more likely than older children to exceed the recommended intakes for phosphorus (p < 0.001) and the age-specific recommended caloric intake (p < 0.001). Macronutrient distribution (carbohydrate:fat:protein) was consistent with recommendation.



Children in the CKiD cohort consumed more sodium, phosphorus, protein, and calories than recommended. The gap between actual consumption and recommendations indicates a need for improved nutritional counseling and monitoring.
Department of Pediatrics, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Wun Fung
0000-0001-5941-1478
WF
Hui
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Aisha
A
Betoko
Department of Pediatrics, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Jonathan D
JD
Savant
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Alison G
AG
Abraham
Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA.
Larry A
LA
Greenbaum
Division of Pediatric Nephrology, Children's Mercy Hospital, Kansas City, MO, USA.
Bradley
B
Warady
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Marva M
MM
Moxey-Mims
Department of Pediatrics, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA. furths@email.chop.edu.
Susan L
SL
Furth
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D004044:Dietary Proteins; D004435:Eating; D002149:Energy Intake; D005260:Female; D005919:Glomerular Filtration Rate; D017408:Guidelines as Topic; D006801:Humans; D007223:Infant; D008297:Male; D009751:Nutritional Requirements; D009752:Nutritional Status; D010758:Phosphorus; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000503:physiopathology; D011795:Surveys and Questionnaires
D004044:Dietary Proteins; D010758:Phosphorus
Children; Chronic kidney disease; Dietary assessment; Nutrient intake
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