PROVIDING THE RIGHT STUFF - FEEDING CHILDREN WITH CHRONIC-RENAL-FAILURE

The progressive loss of renal function in children with chronic renal failure (CRF) has a negative influence on their nutritional status and statural growth. Supportive therapies with 1-25 dihydroxy-vitamin D3, recombinant erythropoietin and growth hormone have significantly impr oved the biochemical and clinical features but the success of these th erapies is largely related to an appropriate diet, with adequate prote in/caloric intakes. Children more than adults have minimal protein req uirements to avoid malnutrition and growth impairment FAO/WHO and RDA recommendations save as guidelines for a correct diet in children with CRF. Following these allowances leads to a ''normoproteic'' diet, wit h a protein intake which is often half the unrestricted one in Western European countries, but which is still likely to be not enough to pro tect against renal deterioration. Indeed the European Study Group for Nutritional Treatment of CRF in children failed to show a significant effect of diet on the mean decline of glomerular filtration rate over two years.