title: Dietary sources of energy and nutrient intake among children and adolescents with chronic kidney disease.
abstract: BACKGROUND
  Our purpose was to identify the main food contributors to energy and nutrient intake in children with chronic kidney disease (CKD).
  
  
  METHODS
  In this cross-sectional study of dietary intake assessed using Food Frequency Questionnaires (FFQ) in the Chronic Kidney Disease in Children (CKiD) cohort study, we estimated energy and nutrient intake and identified the primary contributing foods within this population.
  
  
  RESULTS
  Completed FFQs were available for 658 children. Of those, 69.9% were boys, median age 12 (interquartile range (IQR) 8-15 years). The average daily energy intake was 1968 kcal (IQR 1523-2574 kcal). Milk was the largest contributor to total energy, protein, potassium, and phosphorus intake. Fast foods were the largest contributors to fat and sodium intake, the second largest contributors to energy intake, and the third largest contributors to potassium and phosphorus intake. Fruit contributed 12.0%, 8.7%, and 6.7% to potassium intake for children aged 2-5, 6-13, and 14-18 years old, respectively.
  
  
  CONCLUSIONS
  Children with CKD consumed more sodium, protein, and calories but less potassium than recommended by the National Kidney Foundation (NKF) guidelines for pediatric CKD. Energy, protein, and sodium intake is heavily driven by consumption of milk and fast foods. Limiting contribution of fast foods in patients with good appetite may be particularly important for maintaining recommended energy and sodium intake, as overconsumption can increase the risk of obesity and cardiovascular complications in that population.
authors.affiliation: Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China.|Division of Pediatric Nephrology, Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Kirstie
authors.initials: K
authors.lastname: Ducharme-Smith
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Davis
authors.affiliation: Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Wun Fung
authors.initials: WF
authors.lastname: Hui
authors.affiliation: Division of Pediatric Nephrology, Children's Mercy Hospital, Kansas City, MO, USA.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Warady
authors.affiliation: Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Furth
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.|Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Alison G
authors.initials: AG
authors.lastname: Abraham
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA. asieweb1@jhu.edu.
authors.forename: Aisha
authors.initials: A
authors.lastname: Betoko
mesh_terms: D000293:Adolescent; D000818:Animals; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D002149:Energy Intake; D057140:Fast Foods / Q000009:adverse effects; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D008892:Milk; D009749:Nutrition Surveys; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D064167:Recommended Dietary Allowances; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology*; D012982:Sodium, Dietary / Q000009:adverse effects
chemical_list: D012982:Sodium, Dietary
keywords: Adolescents; Children; Chronic kidney disease; Food; Nutrient intake