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What are Dietary Considerations for a Child with Chronic Renal Failure?

A child in renal failure needs a specialized diet to address the depletion of minerals and vitamins caused by dialysis, and to help avoid certain foods or chemicals, which may worsen renal failure. Because children are growing, renal failure can cause significant setback in growth. This can make a child feel different, in a negative sense, from his or her peers. A diet that takes into consideration the nutrients needed to grow can also help reduce some of the stunting characteristics of dialysis, though it will not completely offset them.

A diet for a child in renal failure has several goals. The child must get sufficient calories, and it helps to try to find foods that a child will eat. The diet must also focus on small frequent meals because a child who is not eating will have quicker deterioration of kidney function. The diet must also attempt to introduce several minerals and vitamins lost in the dialysis process, like calcium, iron, Vitamin C and Vitamin B complex.

Protein intake must be carefully watched, and sodium and potassium are very limited in a renal failure diet. Phosphates are very hard on the kidneys. Excess fluid intake can also create problems significant issues, and fluid must be controlled.

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Diet should be high in protein, but protein should be of good value, and should be low in potassium. Eggs whites are better choices than beans, for example. Milk and meats are high in potassium, and should be used only sparingly.

Carbohydrates provide essential energy, but certain carbohydrates are better since they are lower in potassium. Rice, for example is lower in potassium than wheat and is a much better choice. Fruits like apples, pears, pineapples and papayas are lower in potassium that foods like grapes, or most orange flesh fruits like melons and peaches.

Sodium intake must be very low, which means that almost all packaged or commercially prepared foods are not on the approved list. Vitamin supplementation is virtually always required since calcium is especially affected by the needed diet. Natural calcium sources like milk and leafy green vegetables both pack a high amount of potassium.

Since salt frequently makes things taste good, children may frown at their low salt diets. It helps a diet to spice up foods with garlic or onions, spice mixes that don’t contain salt, or low salt alternatives to regular condiments.

Consulting with a pediatric dietitian is usually the best way to help plan meals and calculate frequency of meals so that the diet follows guidelines for best kidney health, addresses the needs of the growing child, and is also palatable. Pediatric dietitians can often be very creative in developing recipes that children will find acceptable replacements to foods they can no longer eat.

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