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Desloovere A, Renken-Terhaerdt J, Tuokkola J, et al. The dietary management of potassium in children with CKD stages 2-5 and on dialysis-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce. Pediatr Nephrol. 2021;36(6):1331-1346doi: 10.1007/s00467-021-04923-1.
Desloovere, A., Renken-Terhaerdt, J., Tuokkola, J., Shaw, V., Greenbaum, L. A., Haffner, D., Anderson, C., Nelms, C. L., Oosterveld, M. J. S., Paglialonga, F., Polderman, N., Qizalbash, L., Warady, B. A., Shroff, R., & Vande Walle, J. (2021). The dietary management of potassium in children with CKD stages 2-5 and on dialysis-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce. Pediatric nephrology (Berlin, Germany), 36(6), 1331-1346. https://doi.org/10.1007/s00467-021-04923-1
Desloovere, An, et al. "The dietary management of potassium in children with CKD stages 2-5 and on dialysis-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce." Pediatric nephrology (Berlin, Germany) vol. 36,6 (2021): 1331-1346. doi: https://doi.org/10.1007/s00467-021-04923-1
Desloovere A, Renken-Terhaerdt J, Tuokkola J, Shaw V, Greenbaum LA, Haffner D, Anderson C, Nelms CL, Oosterveld MJS, Paglialonga F, Polderman N, Qizalbash L, Warady BA, Shroff R, Vande Walle J. The dietary management of potassium in children with CKD stages 2-5 and on dialysis-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce. Pediatr Nephrol. 2021 Jun;36(6):1331-1346. doi: 10.1007/s00467-021-04923-1. Epub 2021 Mar 17. PMID: 33730284; PMCID: PMC8084813.
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Pediatr Nephrol. 2021 Jun;36(6):1331-1346. doi: 10.1007/s00467-021-04923-1. Epub 2021 Mar 17.

The dietary management of potassium in children with CKD stages 2-5 and on dialysis-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce.

Pediatric nephrology (Berlin, Germany)

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

Affiliations

  1. University Hospital Ghent, Ghent, Belgium.
  2. Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
  3. Children's Hospital and Clinical Nutrition Unit, Internal Medicine and Rehabilitation, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  4. UCL Great Ormond Street Institute of Child Health, London, UK. [email protected].
  5. University of Plymouth, Plymouth, UK. [email protected].
  6. Emory University, Atlanta, GA, USA.
  7. Children's Healthcare of Atlanta, Atlanta, GA, USA.
  8. Children's Hospital, Hannover Medical School, Hannover, Germany.
  9. University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  10. University of Nebraska, Kearney, NE, USA.
  11. Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands.
  12. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  13. British Columbia Children's Hospital, Vancouver, Canada.
  14. Great Northern Children's Hospital, Newcastle upon Tyne, UK.
  15. Children's Mercy Kansas City, Kansas City, MO, USA.
  16. UCL Great Ormond Street Institute of Child Health, London, UK.

PMID: 33730284 PMCID: PMC8084813 DOI: 10.1007/s00467-021-04923-1

Abstract

Dyskalemias are often seen in children with chronic kidney disease (CKD). While hyperkalemia is common, with an increasing prevalence as glomerular filtration rate declines, hypokalemia may also occur, particularly in children with renal tubular disorders and those on intensive dialysis regimens. Dietary assessment and adjustment of potassium intake is critically important in children with CKD as hyperkalemia can be life-threatening. Manipulation of dietary potassium can be challenging as it may affect the intake of other nutrients and reduce palatability. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) for the dietary management of potassium in children with CKD stages 2-5 and on dialysis (CKD2-5D). We describe the assessment of dietary potassium intake, requirements for potassium in healthy children, and the dietary management of hypo- and hyperkalemia in children with CKD2-5D. Common potassium containing foods are described and approaches to adjusting potassium intake that can be incorporated into everyday practice discussed. Given the poor quality of evidence available, a Delphi survey was conducted to seek consensus from international experts. 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. These CPRs will be regularly audited and updated by the PRNT.

Keywords: Children; Chronic kidney disease; Clinical Practice Recommendations (CPRs); Dialysis; Dietary intake; Pediatric Renal Nutrition Taskforce (PRNT); Potassium

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