Micronutrient supplements for chronic renal failure: A survey of pediatric practice

Abstract

• ■ Objective: To review the current micronutrient prescribing practices of pediatric renal units throughout the United Kingdom and Ireland. • ■ Design and participants: Questionnaires were distributed to dietitians who work in 15 designated pediatric renal units. • ■ Main outcome measures: All unit replied with details of the micronutrient supplements prescribed in the three categories: predialysis, chronic dialysis, (peritoneal [CPD], hemodialysis [HD]), and posttransplantation. • ■ Results: Twelve micronutrient supplements (eight vitamin, four combined vitamin/mineral) and seven combinations of supplements are prescribed. Prescription for the predialysis group (four vitamin, two vitamin/mineral, one combination) showed less variation between units, because requirements are individually assessed with guidelines provided by Dietary Reference Values, 1991. A greater number of supplements are prescribed for those on dialysis: CPD (seven vitamin, four vitamin/mineral, six combinations) and HD (eight vitamin, four vitamin/mineral, four combinations). Supplementation after transplantation is not routine unless warranted by individual assessment. • ■ Conclusion: This survey shows that there is no standard policy for vitamin and mineral supplementation of children with chronic renal failure. Further research and discussion regarding micronutrient requirements with development of more palatable preparations is required.