# Nutritional Characterisation of Childhood Chronic Kidney Disease: Trace Element Malnutrition in Paediatric Renal Disease (TeMPeReD) Study

## TL;DR

This study finds that children with early-stage kidney disease often have poor intake of key nutrients like selenium and magnesium, which could affect their health.

## Contribution

The study provides new insights into trace element malnutrition in mild childhood CKD, highlighting dietary fibre's potential role in disease progression.

## Key findings

- 44% of children with CKD showed central obesity despite normal BMI rates.
- 30-35% of children had a high risk of inadequate intake of selenium, magnesium, iodine, and zinc.
- Low dietary fibre intake correlated with greater decline in kidney function over 12 months.

## Abstract

Background/Objectives: In chronic kidney disease (CKD), poor nutrition is associated with poorer clinical outcomes. There are limited data on milder stages of childhood CKD. Methods: This study characterised the nutritional state of a cohort of children with CKD. Results: Within the cohort (mean age 10.5 years, mean eGFR = 57 mL/min/1.73 m2), obesity defined by body mass index rates was comparable to that in the general population, but central obesity (waist-to-height ratio > 0.5) was evident in 44% of children. Although average nutrient intakes for the cohort were acceptable, there was marked variability in the risk of poor nutrient intake (<LRNI): selenium (35%), magnesium (35%), iodine (30%), and zinc (30%). No child met the recommended dietary fibre intake. The prevalence of frank deficiency of vitamins and minerals in blood concentrations was low. Blood concentrations of vitamins A and E were near-universally elevated. In those who had a decline in kidney function at the 12-month follow-up, dietary intake of fibre correlated with the degree of decline. Conclusions: Much work is needed to optimise the nutritional status of children with CKD as an important modifiable risk factor for disease progression and other important outcomes.