# The dietary management of sodium in children with kidney diseases—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

## TL;DR

This paper provides dietary guidelines for managing sodium in children with kidney diseases to prevent complications like hypertension and growth failure.

## Contribution

The paper introduces clinical practice recommendations developed by international experts for sodium management in pediatric kidney disease patients.

## Key findings

- Sodium excess in children with kidney diseases can lead to fluid overload and hypertension.
- Increased sodium losses can cause hypotension and growth failure, requiring tailored dietary strategies.
- The CPRs include guidance on assessing sodium intake and adjusting it based on individual patient needs.

## Abstract

Sodium imbalance is a common concern in children with kidney diseases, presenting as either sodium excess or sodium deficit, each with significant clinical implications. Sodium excess contributes to fluid overload and hypertension, while increased sodium losses, particularly via urine or peritoneal fluid, can predispose patients to hypotension and growth failure. Effective sodium management is thus a critical component of care in pediatric kidney diseases, with dietary sodium intake playing a pivotal role in maintaining homeostasis. The Pediatric Renal Nutrition Taskforce (PRNT) has developed clinical practice recommendations (CPRs) for dietary sodium management in children with kidney diseases, addressing key aspects of sodium balance, including primary dietary sources, nutritional assessment of sodium intake, non-dietary factors influencing sodium balance, and recommended intakes. Strategies for reducing sodium intake in cases of sodium excess and augmenting intake in patients with increased sodium losses are also provided. The consensus of international experts was assessed through a Delphi process. These CPRs will be regularly updated by the PRNT.

The online version contains supplementary material available at 10.1007/s00467-025-06913-z.