Question:  What to do for Facing the Challenges of Chronic Kidney Disease in Children ?
Answer: For children with CKD, learning about nutrition is vital because their diet can affect how well their kidneys work. Parents or guardians should always consult with their childs health care team before making any dietary changes. Staying healthy with CKD requires paying close attention to the following elements of a diet:
                
- Protein. Children with CKD should eat enough protein for growth while limiting high protein intake. Too much protein can put an extra burden on the kidneys and cause kidney function to decline faster. Protein needs increase when a child is on dialysis because the dialysis process removes protein from the childs blood. The health care team recommends the amount of protein needed for the child. Foods with protein include      - eggs    - milk    - cheese    - chicken    - fish    - red meats    - beans    - yogurt    - cottage cheese    - Sodium. The amount of sodium children need depends on the stage of their kidney disease, their age, and sometimes other factors. The health care team may recommend limiting or adding sodium and salt to the diet. Foods high in sodium include      - canned foods    - some frozen foods    - most processed foods    - some snack foods, such as chips and crackers    - Potassium. Potassium levels need to stay in the normal range for children with CKD, because too little or too much potassium can cause heart and muscle problems. Children may need to stay away from some fruits and vegetables or reduce the number of servings and portion sizes to make sure they do not take in too much potassium. The health care team recommends the amount of potassium a child needs. Low-potassium fruits and vegetables include      - apples    - cranberries    - strawberries    - blueberries    - raspberries    - pineapple    - cabbage    - boiled cauliflower    - mustard greens    - uncooked broccoli   High-potassium fruits and vegetables include      - oranges    - melons    - apricots    - bananas    - potatoes    - tomatoes    - sweet potatoes    - cooked spinach    - cooked broccoli    - Phosphorus. Children with CKD need to control the level of phosphorus in their blood because too much phosphorus pulls calcium from the bones, making them weaker and more likely to break. Too much phosphorus also can cause itchy skin and red eyes. As CKD progresses, a child may need to take a phosphate binder with meals to lower the concentration of phosphorus in the blood. Phosphorus is found in high-protein foods. Foods with low levels of phosphorus include      - liquid nondairy creamer    - green beans    - popcorn    - unprocessed meats from a butcher    - lemon-lime soda    - root beer    - powdered iced tea and lemonade mixes    - rice and corn cereals    - egg whites    - sorbet    - Fluids. Early in CKD, a childs damaged kidneys may produce either too much or too little urine, which can lead to swelling or dehydration. As CKD progresses, children may need to limit fluid intake. The health care provider will tell the child and parents or guardians the goal for fluid intake.
                
More information is provided in the NIDDK health topics, Nutrition for Chronic Kidney Disease in Children and Kidney Failure: Eat Right to Feel Right on Hemodialysis.