• Protein Requirements for Children with Advanced Chronic Kidney Disease (CKD): A Clinical Recommendations
  • Mojtaba Hajipour,1 Sahar Arabpour,2 Nazanin Mahboobi,3 Andisheh Norouzian Ostad,4,*
    1. Bachelor student of Nutrition, Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.
    2. Bachelor student of Nutrition, Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.
    3. Bachelor student of Nutrition, Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.
    4. MD-Ph.D. of nutrition science, Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.


  • Introduction: Since children with chronic kidney disease (CKD) often have low growth, it is significant for them to get sufficient protein, particularly for children on peritoneal dialysis (PD) and hemodialysis (HD). In this study, we need to reveal sufficient protein for children with chronic kidney disease.
  • Methods: To accomplish this narrative review, we searched 4 Databases (PubMed, Web of Science, Scopus and google scholar) based on the search strategy from 2010 to 2022 with the high sensitivity on September 2022 by following MeSH keywords: " Chronic Kidney Disease ", " Children ", " Protein requirements ", " Peritoneal dialysis ", " Hemodialysis ".
  • Results: Some studies suggest that the protein required in children with chronic kidney disease stages 2–5 and those on hemodialysis (CKD2-5D) is higher than in healthy children. It was recommended that dietary protein intake be maintained at 100% of the Dietary Reference Intakes (DRI) for the ideal body weight, plus an allowance for dialytic protein and amino acid losses. So, the protein requirement for children on peritoneal dialysis is 0.15–0.3 g/kg/day and for children on hemodialysis is 0.1 g/kg/day. Nitrogen balance can be used to estimate the amount of protein required. Dietary protein reduction, which increases the risk of malnutrition and stunted growth in children in the early stages of CKD, should be avoided. However, reducing protein intake can help improve metabolic control in some cases, provided the nutritional status is maintained.
  • Conclusion: Recent studies have recommended that adequate protein intake is essential for children with CKD. Although protein reduction, in some cases, is necessary, more clinical studies are required.
  • Keywords: Children; Protein requirements; Chronic Kidney disease; Peritoneal dialysis; Hemodialysis