Dietary Guidelines for Children on Hemodialysis

Kidneys filters waste materials and toxins that enters into the body. The child with chronic kidney disease gradually loses kidneys filtering function.  Children with less than 10% of glomerular filtration rate need dialysis. Children on dialysis needs special diet which is different from each child.

Here are some of the best nutritional guidelines for children with chronic renal failure are:

Energy:

The energy intake is taken based on the weight loss or gain to maintain body composition and also to promote health, growth and development. And should be adjusted for physical activity, body size and weight of the individuals.

Protein:

For optimal growth of children, protein intake should be higher in children because of dialysate losses. Also, to avoid metabolic acidosis protein intake should be adjusted in children with high blood urea nitrogen concentrations. Children on hemodialysis should have dietary protein intake according to RDA with additional increment of 0.4 gm/kg/day.

Potassium:

Children on dialysis are risk at both hypokalemia and hyperkalemia. So, restriction of potassium in young children should be 40-120 mg/kg/day and older children 30-40mg/kg/day. It is important to educate children families with hyperkalemia and foods containing high and low potassium levels.

Phosphorous:

The diet which is high in protein also has phosphorous, so choose wisely to get protein without phosphorous. 800-1000 mg of phosphorous per a day should be given. High phosphorous also cause weakening of child’s bones and builds up in child’s blood. Limit intake of foods that are high in phosphorous such as milk, yogurt, meats, dried beans and nuts. And should avoid foods containing phosphate addictive.

Sodium:

Low sodium intake in children can lead to dehydration and poor weight gain in some children. High sodium also causes increased blood pressure. Diet should contain only 2000 mg of sodium per day.  which are high in sodium should be avoided. And diet should include fresh vegetables and fruits, and choose unprocessed foods and also use spices, herbs instead of salt. Avoid junk foods and preserved snacks such as chips, namkeen, frozen foods etc which will have sodium in the form of preservatives.

Fluid:

Fluid intake should be limited based on the child urine output, too much fluid intake can build up in child’s face, legs, arms. Diet which is low in sodium may prevent fluid retention in the body, the amount of child drinks each day is often related to sodium intake also. Higher the salt in the child’s diet, higher is the fluid.

It is quite challenging to make a child follow a renal dialysis diet but with sufficient advice and proper planning with a qualified dietician, you can make wise decisions, make an appealing meal plan which the child would enjoy and feel normal on dialysis.

By,

Prasanna T

Executive Dietician, NephroPlus