Journal article
Assessment and management of magnesium and trace element status in children with CKD stages 2-5, on dialysis and post-transplantation: Clinical practice points from the Pediatric Renal Nutrition Taskforce
Pediatric nephrology (Berlin, West), Vol.40(10), pp.3301-3323
10/2025
DOI: 10.1007/s00467-025-06759-5
PMCID: PMC12402044
PMID: 40379985
Abstract
Children and young people with chronic kidney disease (CKD) are at risk for deficiency or excess of magnesium and trace elements. Kidney function, dialysis, medication, and dietary and supplemental intake can affect their biochemical status. There is much uncertainty about the requirements of magnesium and trace elements in CKD, which leads to variation in practice. The Pediatric Renal Nutrition Taskforce is an international team of pediatric kidney dietitians and pediatric nephrologists, formed to develop evidence-based clinical practice points to improve the nutritional care of children with CKD. PICO (patient, intervention, comparator, and outcomes) questions led the literature searches, which were conducted to ascertain current biochemical status, dietary intake, and factors leading to requirements differing from healthy peers, and to guide nutritional care of children with CKD stages 2-5, on dialysis, and post-transplantation. We address the assessment and intervention of magnesium and the trace elements chromium, copper, fluoride, iodine, manganese, selenium, and zinc. We suggest routine biochemical assessment of magnesium. Trace element assessment is based on clinical suspicion of deficiency or excess and their risk factors, including accumulation, losses, medications, nutrient interactions, and comorbidities. In particular, we suggest assessing magnesium, copper, iodine, and zinc when growth is poor, and evaluating magnesium, copper, selenium, and zinc in the presence of proteinuria. A structured approach to magnesium and trace element management, including biochemical, physical, and dietary assessment, is beneficial in the paucity of evidence. Research recommendations are suggested.
Details
- Title: Subtitle
- Assessment and management of magnesium and trace element status in children with CKD stages 2-5, on dialysis and post-transplantation: Clinical practice points from the Pediatric Renal Nutrition Taskforce
- Creators
- Jetta Tuokkola - University of HelsinkiCaroline E Anderson - University of SouthamptonSheridan Collins - Sydney Children’s Hospitals NetworkPearl Pugh - Queen's Medical CentreMolly R Wong Vega - Texas Children's HospitalMatthew Harmer - University Hospital Southampton NHS Foundation TrustLyndsay A Harshman - University of IowaChristina L Nelms - Children's Mercy HospitalBarry Toole - Freeman HospitalAn Desloovere - Ghent University HospitalFabio Paglialonga - Fondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoNonnie Polderman - BC Children's HospitalJosé Renken-Terhaerdt - University Medical Center UtrechtRukshana Shroff - Great Ormond Street HospitalEvelien Snauwaert - Ghent University HospitalStella Stabouli - Aristotle University of ThessalonikiJohan Vande Walle - Ghent University HospitalBradley A Warady - Children's Mercy HospitalVanessa Shaw - Great Ormond Street HospitalLarry A Greenbaum - Emory University
- Resource Type
- Journal article
- Publication Details
- Pediatric nephrology (Berlin, West), Vol.40(10), pp.3301-3323
- DOI
- 10.1007/s00467-025-06759-5
- PMID
- 40379985
- PMCID
- PMC12402044
- NLM abbreviation
- Pediatr Nephrol
- ISSN
- 0931-041X
- eISSN
- 1432-198X
- Publisher
- SPRINGER
- Grant note
- University of Helsinki (including Helsinki University Central Hospital)Vitaflo International Ltd.Pediatric Renal Nutrition TaskforceRiyadh, Saudi ArabiaHolmes, A, Liverpool, UKNetherlands
Vitaflo International Ltd. is a nutrition company that produces specialized clinical nutrition products for metabolic disorders, nutrition support, and specific conditions such as kidney disease. Vitaflo International Ltd. has funded the meetings held by the Pediatric Renal Nutrition Taskforce. Participants in the Delphi survey: Pediatric Nephrologists: Ahn, Y. H., Seoul, Republic of Korea; Aviles, D., New Orleans, USA; Besouw, M., Groningen, The Netherlands; Di Sessa, A., Naples, Italy; Eid, L., Dubai, UAE; Ehlayel, A., Riyadh, Saudi Arabia; Errichiello, C., Florence, Italy; Hahn, D., Sydney, Australia; Haskin, O., Petah-Tikva, Israel; Johnstone, L., Melbourne, Australia; Ma, Alison, Hong Kong, Marida; M, Modugno, Italy; Moudgil, A., Washington DC, USA; McCulloch, M., Cape Town, South Africa; Prikhodina, L., Moscow, Russia; Prytula, A., Ghent, Belgium; and Schmitt, C., Heidelberg, Germany. Dietitians: Boquette, L., Boise, USA; Campana, C., Roma, Italy; Diswall, T., Lund, Sweden; Ezzat, M, Riyadh, Saudi Arabia; Friedlander, A, Auckland, New Zealand; Holmes, A, Liverpool, UK; Parnarauskiene, J., Vilnius, Lithuania; Sahni, N., Chandigarh, India; Sgambat, K., Washington DC, USA; Taviani, G., Empoli, Italy; Winderlich, J., Melbourne, Australia; Yeung, C., Hong Kong; and Zwolsman, M., Groningen, The Netherlands
- Language
- English
- Electronic publication date
- 05/17/2025
- Date published
- 10/2025
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Radiation Oncology
- Record Identifier
- 9984824330902771
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