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Pediatric Nephrology
Published in: Pediatric Nephrology 4/2021

Open Access 01-04-2021 | Nutrition | Guidelines

Assessment of nutritional status in children with kidney diseases—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

Authors: Christina L. Nelms, Vanessa Shaw, Larry A. Greenbaum, Caroline Anderson, An Desloovere, Dieter Haffner, Michiel J. S. Oosterveld, Fabio Paglialonga, Nonnie Polderman, Leila Qizalbash, Lesley Rees, José Renken-Terhaerdt, Jetta Tuokkola, Johan Vande Walle, Rukshana Shroff, Bradley A. Warady

Published in: Pediatric Nephrology | Issue 4/2021

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Abstract

In children with kidney diseases, an assessment of the child’s growth and nutritional status is important to guide the dietary prescription. No single metric can comprehensively describe the nutrition status; therefore, a series of indices and tools are required for evaluation. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists who develop clinical practice recommendations (CPRs) for the nutritional management of children with kidney diseases. Herein, we present CPRs for nutritional assessment, including measurement of anthropometric and biochemical parameters and evaluation of dietary intake. The statements have been graded using the American Academy of Pediatrics grading matrix. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. Audit and research recommendations are provided. The CPRs will be periodically audited and updated by the PRNT.
Appendix
Available only for authorised users
Glossary
Arm span
span from the tip of the third finger on the one hand across the body to the third finger on the other hand
Demi-span
span from the center of the chest to the tip of the third finger
Euvolemic
weight without additional or inadequate body fluid
Food recall
verbal collection of past food intake
Food record
prospective record of food intake over 24–72 h or longer
IDPN (intradialytic parenteral nutrition)
nutrition given via the hemodialysis access during a hemodialysis session
Length
term used for recumbent linear measurement
Length or height for age
length or height in relation to age norms
MUAC
measurement of the arm circumference in between the elbow and shoulder
NFPE
physical evaluation of a patient to determine risk for malnutrition and potential micronutrient, protein, or fluid concerns
nPCR
a calculation of protein nitrogen appearance in patients on dialysis and used to assess dietary protein intake
PNA (protein nitrogen appearance)
protein catabolism calculation, reflecting dietary protein intake
SDS (standard deviation score)
amount of positive or negative distance from the mean
PEW
a term for malnutrition specific to muscle losses related to specific medical conditions
TSF (triceps skinfold)
amount of fatty tissue that can be pulled away from the muscle of the upper arm
Ulna length
length from the olecranon process to the scaphoid process used to estimate linear height via use of standard equations
Weight for length
the ratio of weight to linear growth in young children
Weight for age
the ratio of weight in relation to age norms
WHr
the numerical ratio of the waist circumference to linear height
z-score
distance from the mean
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Metadata
Title
Assessment of nutritional status in children with kidney diseases—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce
Authors
Christina L. Nelms
Vanessa Shaw
Larry A. Greenbaum
Caroline Anderson
An Desloovere
Dieter Haffner
Michiel J. S. Oosterveld
Fabio Paglialonga
Nonnie Polderman
Leila Qizalbash
Lesley Rees
José Renken-Terhaerdt
Jetta Tuokkola
Johan Vande Walle
Rukshana Shroff
Bradley A. Warady
Publication date
01-04-2021
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 4/2021
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-020-04852-5

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