Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Pediatr Nephrol. 2025 Jan;40(1):15-24. doi: 10.1007/s00467-024-06436-z. Epub 2024 Jul 2.
Chronic kidney disease (CKD) encompasses diverse conditions such as congenital anomalies, glomerulonephritis, and hereditary nephropathies, necessitating individualized nutritional interventions. Early detection is pivotal due to the heightened risk of adverse outcomes, including compromised growth and increased healthcare costs. The nutritional assessment in pediatric CKD employs a comprehensive, multidisciplinary approach, considering disease-specific factors, growth metrics, and dietary habits. The prevalence of malnutrition, as identified through diverse tools and guidelines, underscores the necessity for regular and vigilant monitoring. Nutritional management strategies seek equilibrium in calorie intake, protein requirements, and electrolyte considerations. Maintaining a well-balanced nutritional intake is crucial for preventing systemic complications and preserving the remaining kidney function. The nuanced landscape of enteral nutrition, inclusive of gastrostomy placement, warrants consideration in scenarios requiring prolonged support, with an emphasis on minimizing risks for optimized outcomes. In conclusion, the ongoing challenge of managing nutrition in pediatric CKD necessitates continuous assessment and adaptation. This review underscores the significance of tailored dietary approaches, not only to foster growth and prevent complications but also to enhance the overall quality of life for children grappling with CKD.
慢性肾脏病(CKD)包括多种病症,如先天异常、肾小球肾炎和遗传性肾病,需要进行个体化的营养干预。由于存在不良结局风险升高的情况,包括生长受损和医疗保健费用增加,早期发现至关重要。儿科 CKD 的营养评估采用全面、多学科的方法,考虑疾病特异性因素、生长指标和饮食习惯。通过各种工具和指南确定的营养不良患病率强调了定期和警惕监测的必要性。营养管理策略旨在平衡热量摄入、蛋白质需求和电解质考虑。保持均衡的营养摄入对于预防全身并发症和保护剩余肾功能至关重要。在需要长期支持的情况下,包括胃造口术放置在内的肠内营养的细微景观需要考虑,重点是最小化风险以实现优化结果。总之,管理儿科 CKD 中的营养是一个持续的挑战,需要不断评估和调整。本综述强调了针对特定饮食方法的重要性,不仅可以促进生长和预防并发症,还可以提高与 CKD 作斗争的儿童的整体生活质量。