TAILIEUCHUNG - Guidelines for the Nutritional Management of Children With Renal Disease

Cushing’s disease is rare in children and adolescents. We report the clinical presenta- tions of three children with Cushing’s disease. All three exhibited the typical symptoms and signs of weight gain and growth retardation. Two also demonstrated personality changes, hypertension and hypokalemia, the last of these being rarely reported in patients with Cushing’s disease. Lack of diurnal changes in serum cortisol levels was the most common biochemical finding. Serum cortisol levels were suppressed by low- dose dexamethasone in one patient, which is not typical for patients with Cushing’s disease. Imaging studies are essential for localizing the tumor. Transsphenoidal surgery remains the treatment. | NHS Greater Glasgow and Clyde Guidelines for the Nutritional Management of Children With Renal Disease Dietetics Department Royal Hospital For Sick Children Women Children s Directorate Nutrition in Renal Disease Version Page 1 of 10 Author Kerry Walker Authorised by Dr TJ Beattie Issue Date October 2006 Date of Review March 2013 Q-Pulse Ref YOR-DIET-001 w IW Contents Page Number s 1. Introduction 2 2. Nutrition in Chronic Renal Failure 3 Infants 4 Weaning 5 Children and Adolescents 5 Protein 5 Phosphate 5 Potassium 6 Vitamins and Minerals 6 Enteral Feeds 6 Dialysis 6 Electrolyte Supplements 7 3. Nutritional Requirements in Acute Renal Failure 7 Infants 8 Children and Adolescents 8 Enteral Feeding 8 Vitamins and Minerals 8 4. Nutritional Requirements in Nephrotic Syndrome 8 Initial Dietary Management 9 Ongoing Management 9 5. Nutrition in Renal Transplantation 9 Initial Management 9 General Management 10 6. Future Guideline Development 10 7. References 10 1. INTRODUCTION This guideline has been developed for dietitians and medical staff to assist in the nutritional management of infants and children with renal disease within Yorkhill Division. Specifically these guidelines detail nutritional requirements in Chronic Renal Failure in infants and children. Acute Renal Failure in infants and children Nephrotic Syndrome Renal Transplantation Nutrition in Renal Disease Version Page 2 of 10 Author Kerry Walker Authorised by Dr TJ Beattie Issue Date October 2006 Date of Review March 2013 Q-Pulse Ref YOR-DIET-001 ffil ffi il 2. NUTRITIONAL REQUIREMENTS IN CHRONIC RENAL FAILURE Energy kcal kg day Protein g kg day Predialysis Preterm 120 - 180 - 0 - 6mths 115 - 150 - 6mths - 1yr 95 - 150 - 1 - 2yrs 95 - 120 - Over 2yrs Minimum of EAR for height age - Peritoneal Dialysis Preterm 120 - 180 3 - 4 0 - 6mths 115 - 150 - 3 6mths - 1 yr 95 - 150

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