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Open Access 14-02-2023 | Nutrition | Guidelines

Diagnosis and management of mineral and bone disorders in infants with CKD: clinical practice points from the ESPN CKD-MBD and Dialysis working groups and the Pediatric Renal Nutrition Taskforce

Authors: Justine Bacchetta, Claus Peter Schmitt, Sevcan A. Bakkaloglu, Shelley Cleghorn, Maren Leifheit-Nestler, Agnieszka Prytula, Bruno Ranchin, Anne Schön, Stella Stabouli, Johan Van de Walle, Enrico Vidal, Dieter Haffner, Rukshana Shroff

Published in: Pediatric Nephrology | Issue 9/2023

Abstract

Background

Infants with chronic kidney disease (CKD) form a vulnerable population who are highly prone to mineral and bone disorders (MBD) including biochemical abnormalities, growth retardation, bone deformities, and fractures. We present a position paper on the diagnosis and management of CKD-MBD in infants based on available evidence and the opinion of experts from the European Society for Paediatric Nephrology (ESPN) CKD-MBD and Dialysis working groups and the Pediatric Renal Nutrition Taskforce.

Methods

PICO (Patient, Intervention, Comparator, Outcomes) questions were generated, and relevant literature searches performed covering a population of infants below 2 years of age with CKD stages 2–5 or on dialysis. Clinical practice points (CPPs) were developed and leveled using the American Academy of Pediatrics grading matrix. A Delphi consensus approach was followed.

Results

We present 34 CPPs for diagnosis and management of CKD-MBD in infants, including dietary control of calcium and phosphate, and medications to prevent and treat CKD-MBD (native and active vitamin D, calcium supplementation, phosphate binders).

Conclusion

As there are few high-quality studies in this field, the strength of most statements is weak to moderate, and may need to be adapted to individual patient needs by the treating physician. Research recommendations to study key outcome measures in this unique population are suggested.

Graphical Abstract

Available only for authorised users

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Title: Diagnosis and management of mineral and bone disorders in infants with CKD: clinical practice points from the ESPN CKD-MBD and Dialysis working groups and the Pediatric Renal Nutrition Taskforce
Authors: Justine Bacchetta
Claus Peter Schmitt
Sevcan A. Bakkaloglu
Shelley Cleghorn
Maren Leifheit-Nestler
Agnieszka Prytula
Bruno Ranchin
Anne Schön
Stella Stabouli
Johan Van de Walle
Enrico Vidal
Dieter Haffner
Rukshana Shroff
Publication date: 14-02-2023
Publisher: Springer Berlin Heidelberg
Keywords: Nutrition
Chronic Kidney Disease
Cinacalcet
Published in: Pediatric Nephrology / Issue 9/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-022-05825-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diagnosis and management of mineral and bone disorders in infants with CKD: clinical practice points from the ESPN CKD-MBD and Dialysis working groups and the Pediatric Renal Nutrition Taskforce

Abstract

Background

Methods

Results

Conclusion

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Graphical Abstract

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