Dietary calcium intake does not meet the nutritional requirements of children with chronic kidney disease and on dialysis.
Pediatr Nephrol
; 35(10): 1915-1923, 2020 10.
Article
in En
| MEDLINE
| ID: mdl-32385527
ABSTRACT
BACKGROUND:
Adequate calcium (Ca) intake is required for bone mineralization in children. We assessed Ca intake from diet and medications in children with CKD stages 4-5 and on dialysis (CKD4-5D) and age-matched controls, comparing with the UK Reference Nutrient Intake (RNI) and international recommendations.METHODS:
Three-day prospective diet diaries were recorded in 23 children with CKD4-5, 23 with CKD5D, and 27 controls. Doses of phosphate (P) binders and Ca supplements were recorded.RESULTS:
Median dietary Ca intake in CKD4-5D was 480 (interquartile range (IQR) 300-621) vs 724 (IQR 575-852) mg/day in controls (p = 0.00002), providing 81% vs 108% RNI (p = 0.002). Seventy-six percent of patients received < 100% RNI. In CKD4-5D, 40% dietary Ca was provided from dairy foods vs 56% in controls. Eighty percent of CKD4-5D children were prescribed Ca-based P-binders, 15% Ca supplements, and 9% both medications, increasing median daily Ca intake to 1145 (IQR 665-1649) mg/day; 177% RNI. Considering the total daily Ca intake from diet and medications, 15% received < 100% RNI, 44% 100-200% RNI, and 41% > 200% RNI. Three children (6%) exceeded the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) upper limit of 2500 mg/day. None with a total Ca intake < RNI was hypocalcemic, and only one having > 2 × RNI was hypercalcemic.CONCLUSIONS:
Seventy-six percent of children with CKD4-5D had a dietary Ca intake < 100% RNI. Restriction of dairy foods as part of a P-controlled diet limits Ca intake. Additional Ca from medications is required to meet the KDOQI guideline of 100-200% normal recommended Ca intake. Graphical abstract.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Calcification, Physiologic
/
Calcium, Dietary
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Renal Dialysis
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Renal Insufficiency, Chronic
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Hyperphosphatemia
Type of study:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Adolescent
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Child
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Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Pediatr Nephrol
Journal subject:
NEFROLOGIA
/
PEDIATRIA
Year:
2020
Document type:
Article
Affiliation country: