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Differences in Dietary Intake and Vitamin and Mineral Status of Infants and Children on Dialysis Receiving Feeds or Eating Normal Food

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Differences in Dietary Intake and Vitamin and Mineral Status of Infants and Children on Dialysis Receiving Feeds or Eating Normal Food

Objectives

Knowledge of the vitamin and mineral intake and status of children on dialysis is
scarce. Guidelines suggest supplementation of water-soluble vitamins, but the need
for supplementation of minerals is less clear. We evaluated vitamin and mineral intake
and status of children on chronic dialysis in our center.

Methods

We reviewed patient records of all 33 children aged 0-16 years who were treated with
chronic dialysis at a University Hospital between December 2014 and August 2019. Dietary
intake was estimated from feed prescriptions and 3-day food records. Vitamin and mineral
determinations were performed as part of routine care.

Results

Food records or adherence to dietary prescription of feeds were available for 29 children.
Dietary intake of most nutrients was sufficient in children on feeds, but children
not on feeds had low intakes of vitamins D, B1, B2, and B6 as well as zinc, iron,
and calcium from their diet. Insufficient intake was corrected with supplementation.
We discovered some children with blood concentrations below the reference range for
vitamins D (3.1%) and C (15.4%) and copper (16.7%) and selenium (3.1%). In contrast,
various proportions of children with blood concentrations above the reference range
were detected for all nutrients apart from vitamin D.

Conclusions

In our study, children receiving sufficient amounts of renal-specific feeds to meet
at least 100% of age-specific requirements do not appear to need multivitamin-mineral
supplementation, apart from vitamin D and calcium; in addition, children on PD usually
need a sodium supplement and, on rare occasions with low intake from feeds, a phosphate
supplement is needed. This study further revealed that other children at our center
are more prone to deficient intakes of several vitamins and minerals, requiring supplementation
based on dietetic review and, in some instances, laboratory measurements.

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