Does the Nutritional Intake and Diet Quality of Children With Chronic Kidney Disease Differ From Healthy Controls? A Comprehensive Evaluation

Rachel Lindeback; Rasha Abdo; Lyndal Schnabel; Renee Le Jambre; Sean E Kennedy; Tamarah Katz; Chee Y Ooi; Kelly Lambert

doi:10.1053/j.jrn.2023.12.002

Does the Nutritional Intake and Diet Quality of Children With Chronic Kidney Disease Differ From Healthy Controls? A Comprehensive Evaluation

J Ren Nutr. 2023 Dec 19:S1051-2276(23)00229-7. doi: 10.1053/j.jrn.2023.12.002. Online ahead of print.

Authors

Rachel Lindeback¹, Rasha Abdo², Lyndal Schnabel², Renee Le Jambre³, Sean E Kennedy³, Tamarah Katz³, Chee Y Ooi⁴, Kelly Lambert²

Affiliations

¹ Department of Nutrition and Dietetics, St George Hospital, Sydney, New South Wales, Australia. Electronic address: Rachel.lindeback@health.nsw.gov.au.
² Nutrition and Dietetics, University of Wollongong, School of Medical, Indigenous and Health Sciences, Wollongong, New South Wales, Australia.
³ Department of Nutrition and Dietetics, Sydney Children's Hospital Network, Randwick, Sydney, New South Wales, Australia.
⁴ Discipline of Paediatrics and Child Health, University of New South Wales, School of Clinical Medicine, Discipline of Paediatrics and Child Health, UNSW Medicine and Health, Sydney, New South Wales, Australia.

PMID: 38128854
DOI: 10.1053/j.jrn.2023.12.002

Abstract

Objective: Children with chronic kidney disease (CKD) experience many obstacles to achieving optimal dietary intake. Dietary intake patterns remain unexplored or poorly described. This study compares nutritional intake and diet quality of Australian children with CKD to controls.

Methods: A food frequency questionnaire captured intake data and was compared to controls. Nutritional intake was determined using individualized nutrient reference values, and diet quality described using the Australian Guide to Healthy Eating and the Australian Child and Adolescent Recommended Food Score.

Results: Children with CKD (n = 36) and controls (n = 82) were studied. Children with CKD had lower weight and height z scores, but higher body mass index (P < .0001 for all parameters). Children with CKD had adequate energy intake, and excessive protein and sodium intake (336% and 569%). They were significantly less likely to meet requirements for vitamin A (P < .001), thiamine (P = .006), folate (P = .01), vitamin C (P = .008), calcium (P < .0001), iron (P = .01), magnesium (P = .0009), and potassium (P = .002). No child met recommended vegetable intake; however, less than half of children with CKD met fruit (44%), grains (31%), and dairy serves (31%). They were also less likely to meet recommended fruit and dairy serves (P = .04 and P = .01, respectively). Non-core foods provided 36% of energy, and although comparable to controls, was contributed more by takeaway foods (P = .01).

Conclusion: Children with CKD have reduced nutritional intake of key nutrients and consume more takeaways than controls. Attention to increasing core foods, limiting sodium intake, and managing restrictions while promoting nutrient density appears necessary.

Keywords: Diet; children; chronic kidney disease; diet quality; food frequency questionnaire; nutrition.