Assessment of Dietary Intake of Children with Chronic Kidney Disease

• Type of Material: Article
• Authors: W.F. Hui, Children's Hospital of Philadelphia; Aisha Betoko, Johns Hopkins Bloomberg School of Public Health; Jonathan D. Savant, Children's Hospital of Philadelphia; Alison G. Abraham, Johns Hopkins Bloomberg School of Public Health; Laurence Greenbaum, Emory University; Bradley Warady, Children's Mercy Hospital; Marva M. Moxey-Mims, National Institutes of Health; Susan L. Furth, Children's Hospital of Philadelphia
• Language: English
• Date: 2017-03-01
• Publisher: SPRINGER
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016, IPNA.
• Final Published Version (URL): http://dx.doi.org/10.1007/s00467-016-3491-5
• Title of Journal or Parent Work: Pediatric Nephrology
• Volume: 32
• Issue: 3
• Start Page: 485
• End Page: 494
• Grant/Funding Information: Support for the nutritional analysis of the FFQ was provided by the National Center for Research Resources, Grant UL1RR024134, and is now at the National Center for Advancing Translational Sciences, Grant UL1TR000003.; National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Heart, Lung and Blood Institute (grants U01-DK-66143, U01-DK-66174, U01DK-082194, and U01-DK-66116).; The CKiD Study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute (U01-DK-66143, U01-DK-66174, U01-DK-82194, U01-DK-66116). The CKiD website is located at http://www.statepi.jhsph.edu/ckid.
• Keywords: Dietary assessment; GROWTH; FOOD FREQUENCY QUESTIONNAIRE; Pediatrics; Children; Chronic kidney disease; PRESCHOOL-CHILDREN; Science & Technology; WEIGHT; ADOLESCENTS; PHOSPHORUS; Urology & Nephrology; SALT INTAKE; OBESITY; ENERGY; REPRODUCIBILITY; Life Sciences & Biomedicine; Nutrient intake
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Our aim was to characterize the nutrient intake of children with chronic kidney disease (CKD) relative to recommended intake levels. Methods: We conducted a cross-sectional study of dietary intake assessed by Food Frequency Questionnaire (FFQ) in The North American Chronic Kidney Disease in Children (CKiD) prospective cohort study. Nutrient intake was analyzed to estimate the daily consumption levels of various nutrients and compared with national guidelines for intake. Results: There were 658 FFQs available for analysis; 69.9 % of respondents were boys, with a median age [Interquartile range (IQR)] of 11 years (8–15). Median daily sodium, potassium, and phosphorus intake was 3089 mg (2294–4243), 2384 mg (1804–3076), and 1206 mg (894–1612) respectively. Sodium and phosphorus consumptions were higher than recommended in all age groups. Caloric intake decreased with dropping glomerular filtration rate (GFR) (p = 0.003). The median daily caloric intakes were 1307 kcal in male children 2–3 years old, 1875 kcal in children 4–8 years old, 1923 kcal in those 9–13 years old, and 2427 kcal in those 14–18 years old. Respective levels for girls were 1467 kcal, 1736 kcal, 1803 kcal, and 2281 kcal. Median protein intake exceeded recommended levels in all age groups, particularly among younger participants. Younger children were more likely than older children to exceed the recommended intakes for phosphorus (p < 0.001) and the age-specific recommended caloric intake (p < 0.001). Macronutrient distribution (carbohydrate:fat:protein) was consistent with recommendation. Conclusions: Children in the CKiD cohort consumed more sodium, phosphorus, protein, and calories than recommended. The gap between actual consumption and recommendations indicates a need for improved nutritional counseling and monitoring.