In children with chronic kidney disease (CKD), optimal control of bone and mineral homeostasis is essential, not only for the prevention of debilitating skeletal complications and achieving adequate growth but also for preventing vascular calcification and cardiovascular disease. Complications of mineral bone disease (MBD) are common and contribute to the high morbidity and mortality seen in children with CKD. Although several studies describe the prevalence of abnormal calcium, phosphate, parathyroid hormone, and vitamin D levels as well as associated clinical and radiological complications and their medical management, little is known about the dietary requirements and management of calcium (Ca) and phosphate (P) in children with CKD. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists, who develop clinical practice recommendations (CPRs) for the nutritional management of various aspects of renal disease management in children. We present CPRs for the dietary intake of Ca and P in children with CKD stages 2-5 and on dialysis (CKD2-5D), describing the common Ca- and P-containing foods, the assessment of dietary Ca and P intake, requirements for Ca and P in healthy children and necessary modifications for children with CKD2-5D, and dietary management of hypo- and hypercalcemia and hyperphosphatemia. The statements have been graded, and statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. These CPRs will be regularly audited and updated by the PRNT.

中文翻译：

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CKD 2-5 期儿童的钙和磷酸盐饮食管理以及儿科肾脏营养工作组的透析临床实践建议。


对于患有慢性肾病 (CKD) 的儿童，骨和矿物质稳态的最佳控制至关重要，不仅可以预防骨骼衰弱并发症和实现充分生长，还可以预防血管钙化和心血管疾病。矿物质骨病 (MBD) 的并发症很常见，导致 CKD 儿童的高发病率和死亡率。尽管一些研究描述了钙、磷酸盐、甲状旁腺激素和维生素 D 水平异常的患病率以及相关的临床和放射学并发症及其医疗管理，但人们对钙 (Ca) 和磷酸盐 (P) 的饮食需求和管理知之甚少。 ）患有 CKD 的儿童。儿科肾脏营养工作组 (PRNT) 是一个由儿科肾脏营养师和儿科肾脏病专家组成的国际团队，他们为儿童肾脏疾病管理各个方面的营养管理制定临床实践建议 (CPR)。我们提出了 CKD 2-5 期和透析儿童 (CKD2-5D) 膳食钙和磷摄入量的 CPR，描述了常见的含钙和磷食物、膳食钙和磷摄入量的评估、健康儿童的钙和磷以及 CKD2-5D 儿童的必要调整，以及低钙血症、高钙血症和高磷血症的饮食管理。这些陈述已经过评级，低等级的陈述或基于意见的陈述必须经过仔细考虑，并根据治疗医生和营养师的临床判断来适应个体患者的需求。 PRNT 将定期审核和更新这些 CPR。