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Clinical Practice Recommendations from the Paediatric Renal Nutrition Taskforce

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The Paediatric Renal Nutrition Taskforce comprises paediatric renal dietitians and paediatric nephrologists from 8 countries across Europe and North America who are dedicated to improving the nutritional care of children with kidney diseases. The taskforce is endorsed by ESPN and IPNA. The taskforce have been working on developing clinical practice recommendations for the nutritional management of children with kidney diseases. The following clinical practice recommendations by the taskforce have been published and are available via open access.

In the first short film below, several members of the Paediatric Renal Nutrition Taskforce discuss the work of the Taskforce, what they have gained from being involved with it and how it benefits clinicians across the world. 

The second 7 minute film highlights the resources produced by the Taskforce for healthcare professionals and patients. The film highlights resources which are available on www.myrenalnutrition.com, a website produced by Vitaflo, for patients with kidney disease and their families

 

Below you will find a range of resources created by the Paediatric Renal Nutrition Taskforce (PRNT). There are resources for Healthcare Professional use and for Healthcare Professionals to use with patients. Many of the resources have been adapted and translated for specific countries.

 

Clinical practice recommendations

https://link.springer.com/article/10.1007/s00467-020-04852-5

Webinar recording

On the 23rd February 2021 Dr Rukshana Scroff, Professor Bradley Warady, Christina Nelms, Caroline Anderson and Vanessa Shaw presented on the taskforce clinical practice recommendations.

Watch the recording

Practical Guides for Healthcare Professionals

Download the guide

Clinical practice recommendations

https://doi.org/10.1007/s00467-019-04426-0

The Paediatric Renal Nutrition Taskforce has undertaken a 5-year review of the Clinical Practice Recommendations for Energy and Protein requirements.

There is no need to change the 2019 suggested dietary intakes (SDIs) for Energy and Protein when considering the 2023 Nordic Nutrition Recommendations (NNR)(1) and 2023 Dietary Reference Intakes (DRIs) for Energy published by the National Academies of Sciences, Engineering, and Medicine (NASEM) (2).  There are no, or only small, changes in these new recommendations. As NNR and NASEM are only two of eight published recommendations for energy and protein intakes used to determine the SDIs these small changes have no significant impact on clinical practice.

  1. https://www.norden.org/en/publication/nordic-nutrition-recommendations-2023
  2. https://nap.nationalacademies.org/catalog/26818/dietary-reference-intakes-for-energy

Webinar recording

On 14th April 2021 Dr Michiel Oosterveld, Vanessa Shaw and Nonnie Polderman presented the taskforce recommendations on energy and protein requirements.

Watch the recording

Practical Guides for Healthcare Professionals

Download the guide

Download the guide for Healthcare Professionals practicing in Malaysia 

Clinical practice recommendations

http://link.springer.com/article/10.1007/s00467-019-04370-z

The Paediatric Renal Nutrition Taskforce (PRNT) has undertaken a 5-year review of the Clinical Practice Recommendations for the dietary management of Calcium and Phosphate. 

There is no need to change the 2019 suggested dietary intakes (SDIs) for Calcium and Phosphate when considering the 2023 Nordic Nutrition Recommendations (NNR) (1). There are no, or only small, changes in these new recommendations. As NNR is only one of five published recommendations for calcium and phosphate intakes, these small changes have no significant impact on clinical practice.

Recent publications highlight additional factors for the management of calcium and phosphate. Nutritional adequacy and acid-base balance should be considered when providing dietary advice about calcium and phosphate (2). 

While diet history is the cornerstone of nutritional assessment, estimates of dietary calcium intakes may underestimate true intake as the calcium content of processed foods can vary widely based on production methods and brand, often making nutrient composition tables inaccurate. The quality of diet may also be influenced by socioeconomic status (3).

Metabolic acidosis can cause bone demineralization, leading to osteomalacia and rickets (4). Therefore, a plant-based diet with reduced acidic foods may be advised based on appetite, weight gain and growth. 

  1. https://nap.nationalacademies.org/catalog/26818/dietary-reference-intakes-for-energy
  1. Sravani M, Collins S, Iyengar A (2024) Assessment of Dietary Acid Load in Children with Chronic Kidney Disease: An Observational Study. Indian J Nephrol 34:50-5. https://doi.org/ 10.4103/ijn.ijn_29_23
  2. Rahman RK, Mattilda A, Iyengar A (2023) Assessment of dietary phosphorus intake and implementation of parental phosphate education in pediatric chronic kidney disease. Indian J Nephrol 33:188-94. https://doi.org/10.4103/ijn.ijn_149_21
  3. Bakkaloglu SA, Bacchetta J, Lalayiannis A D et al (2021) Bone evaluation in paediatric chronic kidney disease: clinical practice points from the European Society for Paediatric Nephrology CKD-MBD and Dialysis working groups and CKD-MBD working group of the ERA-EDTA. Nephrology Dialysis Transplantation 36:413–425. https://doi.org/10.1093/ndt/gfaa210

Webinar recording

On 11th June 2021 Dr Rukshana Shroff, Pearl Pugh and Louise McAlister presented the taskforce recommendations for calcium and phosphate. You can watch the full recording in the link below:

Watch the recording

Practical Guides for Healthcare Professionals

Healthcare Professional practical guide

Guides for patients and families

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary phosphate intake.

For families with young children

For young people

These posters categorise food items as high in phosphate additives, high in natural phosphate and lower phosphate alternatives.

Download the posters

Clinical practice recommendations

https://link.springer.com/article/10.1007/s00467-021-04923-1

Webinar recording

On 13 July 2021 Professor Larry Greenbaum, José Renken-Terhaerdt, An Desloovere and Professor Rukshana Shroff highlighted clinical practice recommendations.

Watch the webinar recording

Practical Guides for Healthcare Professionals

Healthcare Professionals practical guide

Guides for patients and families

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary potassium intake.

For families with young children and babies 

For young people

Potassium food tables 

These posters categorise food items into high, low and medium in terms of their potassium content.

Potassium poster

Potassium swap sheet

Clinical practice recommendations

https://link.springer.com/article/10.1007/s00467-020-04623-2

Webinar recording

On 19th October 2021 Professor Rukshana Shroff, Vanessa Shaw and Jetta Tuokkola discussed the taskforce tube feeding recommendations.

Watch the recording

Practical Guides for Healthcare Professionals

Download the guide

Clinical practice recommendations

http://link.springer.com/article/10.1007/s00467-021-05148-y

Webinar recording

On 24th February 2022 Vanessa Shaw, Dr Stella Stabouli, Nonnie Polderman and Christina Nelms discussed the recommendations for obesity and metabolic syndrome.

Watch the recording

Educational review

https://link.springer.com/article/10.1007/s00467-022-05529-x

Webinar recording

The Taskforce chose to split this important topic into two separate events.

The first part was recorded on 21st April 2022, with the second part recorded on 10th May 2022. Both include Vanessa Shaw, Dr. Shroff and paediatric nephrology dietitian, Jose Renken-Terhaerdt.

Watch part 1

Watch part 2 

Clinical practice recommendations

https://doi.org/10.1007/s00467-024-06444-z

Webinar recording

On the 10th October 2023, Vanessa Shaw and Jetta Tuokkola discussed the nutritional management of the child with CKD stages 2-5, and on dialysis as detailed in Paediatric Renal Nutrition Taskforce clinical practice recommendations.

Watch the recording

Clinical practice recommendations

https://doi.org/10.1007/s00467-023-05884-3

Webinar recording

On the 28th of February Professor Larry Greenbaum and Molly Wong Vega discussed the Clinical Practice Recommendations for the nutritional management of children with acute kidney injury.

Watch the recording 

Clinical practice recommendations

https://doi.org/10.1053/j.jrn.2024.05.008

Webinar recording

On the 15th January 2024, Dr Evelien Snauwaert and An Desloovere discussed the management of dietary fibre intake in children with kidney disease - clinical practice recommendations from the Paediatric Renal Nutrition Taskforce.

Watch the recording

Webinar recording

For more information on using a renal-specific low potassium feed whilst achieving optimal fibre intake, watch our webinar with expert speaker and dietitian Pearl Pugh. 

Watch the recording

 

Clinical practice recommendations

https://link.springer.com/article/10.1007/s00467-024-06303-x

Webinar recording

On the 26th February 2024, PRNT members Caroline Anderson and Jetta Tuokkola shared clinical practice points on the assessment and management of vitamin status in children with CKD stages 2-5, on dialysis and post-transplantation. 

Watch the recording

These guides show the phosphate and potassium content of foods commonly eaten in the Middle East:

Renal food guide

Potassium poster

Potassium swap sheet

Practical Guides for Healthcare Professionals

This guide shows the energy and protein content of foods commonly eaten by Turkish families:

Energy and Protein Food Guide

These guides show the phosphate and potassium content of foods commonly eaten by Turkish families:

Phosphate food guide

Potassium food guide

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary phosphate intake.

For families with children

For young people

 

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary potassium intake.

For families with babies

For families with young children

For young people

This poster is to be used by Healthcare Professionals with patients and their families. It provides guidance on how to reduce dietary potassium intake.

Potassium poster

These guides show the potassium content of foods commonly eaten by Indian families:

K management for an Indian diet

West & Central Indian diet

North Indian diet

South Indian diet

 

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary potassium intake.

For families with babies

For families with young children

For young children

 

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary phosphate intake.

For families with young children

For young people

This booklet is to be used by Healthcare Professionals practicing in Malaysia with patients and their families. It provides guidance on the energy and protein requirements in children.

Download the guide

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary potassium intake.

a guide for families with babies and young children

a guide for young people

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary phosphate intake.

a guide for families

a guide for young people

 

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on how to reduce dietary potassium intake.

Potassium guide for families with babies and young children

Potassium guide for young people

These booklets are to be used by Healthcare Professionals with patients and their families. They provide guidance on to reduce dietary phosphate intake.

Phosphate guide for families with babies and young children

Phosphate guide for young people

Download the A4 food poster

 

This booklet is for Healthcare Professionals and details the potassium content of commonly consumed foods and drinks in Israel. It is written in Hebrew. 

Israel potassium food guide in Hebrew

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