Abstract

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The 2008 update of the Kidney Disease Outcomes Quality Initiative (KDOQI) pediatric nutrition clinical practice guideline is intended to assist the practitioner caring for infants, children, and adolescents with chronic kidney disease (CKD) stages 2 to 5, on long-term dialysis therapy, or with a kidney transplant. The guideline contains recommendations for evaluation of nutritional status and growth and for counseling and selecting nutrition therapies that are appropriate to age and CKD stage. Therapeutic interventions considered include enteral feeding, intradialytic parenteral nutrition, growth hormone therapy, and restriction or supplementation of various macro- and micronutrients. The Work Group drafted narrative reviews based on its expertise and knowledge of the literature in the field and used references to support its write-up. Given the heterogeneity and often unique circumstances of the disease conditions in children with CKD, the Work Group adopted a perspective of issuing recommendations of potential use for improving patient survival, health, and quality of life. The recommendations also underwent both internal and external review. Tables of food and formula nutrient content, procedures for anthropometric measurements, copies of growth charts, and a list of resources for calculating energy requirements and anthropometric z scores are provided to assist with implementation. Furthermore, limitations to the recommendations are discussed; comparisons to other guidelines are made; and recommendations are provided for future research.

INDEX WORDS: Infants; children and adolescents; chronic kidney disease; dialysis; kidney transplantation; nutrition; guideline.