Division of Nephrology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, 2300 Tupper Street, Montreal, Quebec, H3H 1P3, Canada.
Pediatr Nephrol. 2012 Sep;27(9):1427-39. doi: 10.1007/s00467-011-1983-x. Epub 2011 Aug 28.
Provision of adequate nutrition is a cornerstone of the management of infants and very young children with chronic kidney disease (CKD). Very young children with CKD frequently have poor spontaneous nutritional intake. Because growth depends strongly on nutrition during early childhood, growth in very young children with CKD is often suboptimal. In this review we will consider the mechanisms and manifestations of inadequate nutritional status in very young children with CKD, mechanisms mediating inadequate nutritional intake, and the optimal nutritional management of this special population. In addition, we suggest an approach to the assessment of nutritional status, including the use of body mass index in infants. Five major nutritional components are considered: energy, macronutrients, fluids and electrolytes, micronutrients, and calcium/phosphorus/vitamin D. The use of adjunctive therapies, including appetite stimulants, treatment of gastroesophageal reflux and gastric dysmotility, enhanced dialytic clearance, and growth hormone, is also briefly discussed.
提供充足的营养是管理慢性肾脏病（CKD）婴幼儿和非常年幼儿童的基石。患有 CKD 的非常年幼的儿童通常自发的营养摄入不足。由于生长在幼儿期强烈依赖于营养，因此患有 CKD 的非常年幼的儿童的生长通常不理想。在这篇综述中，我们将考虑 CKD 非常年幼儿童营养不足的机制和表现、介导营养摄入不足的机制，以及对这一特殊人群的最佳营养管理。此外，我们建议了一种评估营养状况的方法，包括在婴儿中使用体重指数。考虑了五大营养成分：能量、宏量营养素、液体和电解质、微量营养素以及钙/磷/维生素 D。还简要讨论了辅助治疗的使用，包括食欲刺激剂、胃食管反流和胃动力障碍的治疗、增强透析清除率和生长激素。
