| [ Summary ] |
One goal for treatment of children with end-stage renal disease (ESRD) is to achieve normal growth and development. Adequate nutritional management is essential from infancy, along with an early start of dialysis and renal transplantation. However, sufficient dietary intake is frequently difficult and protein / energy malnutrition (PEM) is common in children with ESRD. The main dialytic therapy for children is peritoneal dialysis (PD). When considering glucose absorption from the PD dialysate and protein loss to the dialysate, the protein / energy ratio in childrens' diet on PD is 13 - 15 %, which is almost the same as the diet for normal children. If their activity is below average, decreased energy intake is necessary. Also, protein intake above that recommended should be avoided because of the risk of excess phosphrous intake. In infants on PD, forced feeding and formulas containing high sodium levels are necessary. On the other hand, sodium restriction is needed in older children using automated peritoneal dialysis. Eating problems are common in children with ESRD. A nutritional supporting team (NST) may help both patients and their families. In addition, renal transplantation should be performed as soon as possible. |