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Year : 2019  |  Volume : 5  |  Issue : 1  |  Page : 33

Translating nutritional guidelines for post renal transplant children into practice


Associate Professor, Department of Nephrology, Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Manipal, Karnataka, India

Date of Web Publication15-Nov-2019

Correspondence Address:
Dharshan Rangaswamy
Department of Nephrology, Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Manipal, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrnm.jrnm_49_19

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How to cite this article:
Rangaswamy D. Translating nutritional guidelines for post renal transplant children into practice. J Renal Nutr Metab 2019;5:33

How to cite this URL:
Rangaswamy D. Translating nutritional guidelines for post renal transplant children into practice. J Renal Nutr Metab [serial online] 2019 [cited 2019 Dec 13];5:33. Available from: http://www.jrnm.in/text.asp?2019/5/1/33/271044



Post renal transplant patients require individualized nutritional counseling to prevent side effects of immunosuppression on muscle catabolism and mineral bone disease. Dietary assessment, diet modifications, and counseling are suggested for children with chronic kidney disease (CKD) stages 1 to 5T to meet nutritional requirements.[1] Post-transplant weight gain is a concern for both the nephrologist and the nutritionist. To manage post-transplantation weight gain, it is suggested that energy requirements of children with CKD stages 1 to 5T should be 100% of the estimated energy requirements for chronological age, adjusted for physical activity level (PAL), and body size (i.e., body mass index [BMI]). Further adjustment to energy intake is suggested based on the response in rate of weight gain or loss. To prevent or manage obesity, dyslipidemia, and corticosteroid-induced diabetes in children, calories should be obtained from carbohydrate and unsaturated fats. Dietary modifications are recommended post-transplant patients with hypertension or abnormal serum mineral or electrolyte concentrations associated with immunosuppressive drug therapy or impaired kidney function.

Calcium and Vitamin D intakes should be at least 100% of the Dietary Reference Intake (DRI). Total oral and/or enteral calcium intake from nutritional sources and phosphate binders should not exceed 200% of the DRI.

To avoid excessive weight gain, promote dental health, and avoid hyperglycemia, water, and drinks low in simple sugars can be given as beverages. Children should take high minimum total daily fiuid intakes (except those who are underweight, i.e., BMI-for-height-age <5th percentile).

Since children are on immunosuppressive drugs, therefore, they should be given hygienically and freshly prepared food. They should avoid foods that carry a high risk of food poisoning or food-borne infection.

Financial support and sponsorship

Nil.

Confiicts of interest

There are no confiicts of interest.



 
  References Top

1.
KDOQI Work Group. KDOQI clinical practice guideline for nutrition in children with CKD: 2008 update. Executive summary. Am J Kidney Dis 2009;53:S11-104.  Back to cited text no. 1
    




 

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