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Assessment and management of obesity and metabolic syndrome in children with CKD stages 2–5 on dialysis and after kidney transplantation—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

Assessment and management of obesity and metabolic syndrome in children with CKD stages 2–5 on dialysis and after kidney transplantation—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce
Assessment and management of obesity and metabolic syndrome in children with CKD stages 2–5 on dialysis and after kidney transplantation—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

Obesity and metabolic syndrome (O&MS) due to the worldwide obesity epidemic affects children at all stages of chronic kidney disease (CKD) including dialysis and after kidney transplantation. The presence of O&MS in the pediatric CKD population may augment the already increased cardiovascular risk and contribute to the loss of kidney function. 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 children with kidney diseases. We present CPRs for the assessment and management of O&MS in children with CKD stages 2–5, on dialysis and after kidney transplantation. We address the risk factors and diagnostic criteria for O&MS and discuss their management focusing on non-pharmacological treatment management, including diet, physical activity, and behavior modification in the context of age and CKD stage. The statements have been graded using the American Academy of Pediatrics grading matrix. 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. Research recommendations are provided. The CPRs will be periodically audited and updated by the PRNT.

Chronic kidney disease, Clinical practice recommendations, Diet, Kidney transplantation, Metabolic syndrome, Obesity, Pediatric Renal Nutrition Taskforce, Physical activity, Screen time, Sleep
0931-041X
Stabouli, Stella
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Polderman, Nonnie
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Nelms, Christina L.
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Paglialonga, Fabio
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Oosterveld, Michiel J.S.
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Greenbaum, Larry A.
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Warady, Bradley A.
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Anderson, Caroline
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Haffner, Dieter
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Desloovere, An
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Qizalbash, Leila
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Renken-Terhaerdt, José
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Tuokkola, Jetta
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Walle, Johan Vande
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Shaw, Vanessa
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Mitsnefes, Mark
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Shroff, Rukshana
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Stabouli, Stella
10d1b702-e769-4ed6-a5b1-506505b33ae1
Polderman, Nonnie
e35cd60f-04b1-4766-a78a-3d131bc200b3
Nelms, Christina L.
335b8141-a72a-415a-976c-51a1b9618847
Paglialonga, Fabio
4ec2622c-4126-4300-8dfd-a553f911bdf8
Oosterveld, Michiel J.S.
c204c47c-54cd-4021-9c58-fa4849ffdfdb
Greenbaum, Larry A.
86905264-418c-4ea0-8c31-e8325c319fd7
Warady, Bradley A.
82279cab-ffb7-47b5-b1e2-2b154faca87b
Anderson, Caroline
1af5a611-d726-47c1-ad29-aa90fac736db
Haffner, Dieter
27d2fbbc-8f6f-45fd-9f20-22304623924f
Desloovere, An
81c6ecb0-e5ab-4387-88ca-22e337f7240d
Qizalbash, Leila
498feafa-34fd-47fa-b6d3-b103abaef4a0
Renken-Terhaerdt, José
787feef1-1516-4d59-8ecc-d9f29e62e209
Tuokkola, Jetta
db3197eb-b0ca-4f1a-a0de-0897c10b49aa
Walle, Johan Vande
ed390f33-ef94-4828-89db-1ed05864b968
Shaw, Vanessa
db935afd-fdf2-41f7-9fb0-158943f42235
Mitsnefes, Mark
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Shroff, Rukshana
6052afd5-429e-43d5-a3fd-c184660d5af4

Stabouli, Stella, Polderman, Nonnie, Nelms, Christina L., Paglialonga, Fabio, Oosterveld, Michiel J.S., Greenbaum, Larry A., Warady, Bradley A., Anderson, Caroline, Haffner, Dieter, Desloovere, An, Qizalbash, Leila, Renken-Terhaerdt, José, Tuokkola, Jetta, Walle, Johan Vande, Shaw, Vanessa, Mitsnefes, Mark and Shroff, Rukshana (2021) Assessment and management of obesity and metabolic syndrome in children with CKD stages 2–5 on dialysis and after kidney transplantation—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce. Pediatric Nephrology, 37 (1). (doi:10.1007/s00467-021-05148-y).

Record type: Review

Abstract

Obesity and metabolic syndrome (O&MS) due to the worldwide obesity epidemic affects children at all stages of chronic kidney disease (CKD) including dialysis and after kidney transplantation. The presence of O&MS in the pediatric CKD population may augment the already increased cardiovascular risk and contribute to the loss of kidney function. 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 children with kidney diseases. We present CPRs for the assessment and management of O&MS in children with CKD stages 2–5, on dialysis and after kidney transplantation. We address the risk factors and diagnostic criteria for O&MS and discuss their management focusing on non-pharmacological treatment management, including diet, physical activity, and behavior modification in the context of age and CKD stage. The statements have been graded using the American Academy of Pediatrics grading matrix. 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. Research recommendations are provided. The CPRs will be periodically audited and updated by the PRNT.

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Accepted/In Press date: 18 May 2021
Published date: 10 August 2021
Keywords: Chronic kidney disease, Clinical practice recommendations, Diet, Kidney transplantation, Metabolic syndrome, Obesity, Pediatric Renal Nutrition Taskforce, Physical activity, Screen time, Sleep

Identifiers

Local EPrints ID: 453430
URI: http://eprints.soton.ac.uk/id/eprint/453430
ISSN: 0931-041X
PURE UUID: 432fd40a-5e28-4db4-816b-3ee7c0571d12

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Date deposited: 14 Jan 2022 17:41
Last modified: 17 Mar 2024 12:52

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Contributors

Author: Stella Stabouli
Author: Nonnie Polderman
Author: Christina L. Nelms
Author: Fabio Paglialonga
Author: Michiel J.S. Oosterveld
Author: Larry A. Greenbaum
Author: Bradley A. Warady
Author: Caroline Anderson
Author: Dieter Haffner
Author: An Desloovere
Author: Leila Qizalbash
Author: José Renken-Terhaerdt
Author: Jetta Tuokkola
Author: Johan Vande Walle
Author: Vanessa Shaw
Author: Mark Mitsnefes
Author: Rukshana Shroff

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