Abstract
Children with chronic kidney disease require special nutritional care to ensure optimal growth and development. In children with declining kidney function, failure to thrive is a common problem. There is no universal diet that can be prescribed for these patients, as the nutritional plan must be adapted to the changing needs of the growing child and the stage and progression of chronic kidney disease. We must pay particular attention to energy and protein intake, but, due to various disease states, we also monitor intake of sodium, potassium, calcium, phosphorus, and iron. Achieving a balance between nutrients be a major challenge due to numerous dietary restrictions in children requiring renal replacement therapy. With appropriate nutritional planning and counseling, we can promote optimal growth and development in a child with chronic kidney disease. Besides failure to thrive, obesity as a persisting problem worldwide affects children with chronic kidney disease of all stages, leading to obesity-related renal injurious effects. Both undernutrition and overnutrition are significant challenges in children with chronic kidney disease, and nutritional management encompasses a wide range of measures, from preventing and treating obesity to providing a supportive diet and ensuring adequate protein and energy intake for weight gain and development. Here, we provide a narrative review summarizing pediatric nutritional management, covering topics from early kidney health to advanced chronic kidney disease care, and incorporating the latest findings as well as our own perspectives.