Management of Chronic Kidney Disease

Uraemia is associated with malnutrition and the main cause is an inadequate nutrient intake.  This is a particular concern in small children, as it will contribute to the impaired linear growth associated with chronic renal failure (CRF).

Anorexia is a major factor and can be the result of:

• impaired taste associated with uraemia
• vomiting can be a feature of CRF which may be exacerbated by drug therapies
• inadequate dialysis
• peritoneal dialysis fluid in the abdominal cavity can effect gastric emptying

High protein intakes will exacerbate uraemia and diets with a high carbohydrate content are encouraged. Dietary supplements may be used and if these are not tolerated orally, overnight feeding may be initiated via a gastrostomy tube.