| [ Summary ] |
Pediatric patients with end stage renal failure are usually treated with peritoneal dialysis (PD). Therefore, total calorie intake should be restricted to 90% of normal for that age matching calorie under management of nutrition before renal transplantation regarding absorption of sugar by PD. Protein intake is not eliminated but adjusted to 13 to 15% of the protein/calorie ratio, because it is lost in the PD fluid. Sodium is not restricted except cases of hypertension, edema, fluid collection in the chest or overhydration. In contrast sodium chloride could be given orally to patients with continuous ambulatory PD (CAPD), where sodium is being excreted. In post-transplant nutrition management, total calorie intake should be adequate to re-establish normal growth patterns without any dietary control. However too much sugar intake may evoke a diabetic state, accompanied with the side-effects of steroid administration, tacrolimus or ciclosporin and excess intake of fat and cholesterol may induce obesity and damage the femoral head or knee joints. In the case of 7 years old girl, her pre-transplant daily diet consisted of a total calorie intake of 1400-1500 kcal, while protein intake was 55-60g (a protein/calorie ratio of 15%), fat 50g (the fat/calorie ratio was 25-27%), sugar (the sugar/calorie ratio was 50-55%), and NaCl of 6g. The post-transplant diet was supplied with an 1800 to 1900 kcal total, with a protein intake of 73-77g (protein/calorie ratio of 20%), fat 64-75g (fat/calorie ratio of 20%), sugar (sugar/calorie ratio of 60%) and NaCl 7 to 9g. The patient was able to receive relatively well controlled nutrition, both before and after transplantation. |