Optimizing Nutrition in Neonates with Kidney Dysfunction

Author:

Nesargi Saudamini1,Steflik Heidi2,Kamath Nivedita3,Selewski David4,Gist Katja M.5,Menon Shina6

Affiliation:

1. *Department of Neonatology, St. Johns Medical College Hospital, Bangalore, India

2. †Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC

3. ‡Department of Pediatric Nephrology, St. Johns Medical College Hospital, Bangalore, India

4. §Division of Nephrology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC

5. ¶Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH

6. ∥Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA

Abstract

Abstract The nutritional management of neonates with kidney disease is complex. There may be significant differences in nutritional needs based on the duration and cause of kidney dysfunction, including acute kidney injury (AKI) and chronic kidney disease (CKD). Furthermore, the treatment modality, including acute (continuous renal replacement therapy and peritoneal dialysis [PD]) and chronic (intermittent hemodialysis and PD) approaches may differentially affect nutritional losses and dietary needs. In this review, we discuss the pathophysiology of compromised nutrition in neonates with AKI and CKD. We also summarize the existing data and consensus recommendations on the provision of nutrition to neonates with AKI and CKD. We highlight the paucity of data on micronutrient losses and the need for future prospective studies to enhance nutritional supplementation to hopefully improve outcomes in these patients.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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