CSR Pediatric Renal Nutrition

Question 1

In infants with CKD or ESRD, ensuring adequate caloric intake is critical for growth. What is the MOST common reason infants with CKD fail to thrive despite adequate prescribed calorie intake?

Accepted Answer

Uremic anorexia, vomiting, and oral aversion leading to inadequate actual oral intake — requiring tube feeding supplementation

Answer

Too much protein causing osmotic diarrhea

Answer

Excessive physical activity burning prescribed calories

Answer

Genetic growth hormone resistance unrelated to nutrition

Question 2

Which parameter is the BEST clinical indicator of adequate nutritional support for linear growth in a child with CKD?

Accepted Answer

Height velocity (change in height over time) plotted on standard growth charts compared to age/sex norms

Answer

Serum albumin level maintained > 4.0 g/dL

Answer

Body mass index above the 50th percentile

Answer

Serum blood urea nitrogen < 30 mg/dL

Question 3

For a 3-year-old child with CKD Stage 5 on peritoneal dialysis, caloric requirements per kg body weight are HIGHER or LOWER compared to an adult on PD?

Accepted Answer

Higher — children require more calories per kg (80–120 kcal/kg/day) than adults to support growth and development

Answer

Lower — children need fewer calories per kg than adults

Answer

The same — pediatric and adult requirements per kg are identical

Answer

Only protein requirements differ; energy requirements per kg are the same

Question 4

In a child with CKD Stage 3–4, which vitamin/mineral is MOST critical to monitor and supplement to prevent renal osteodystrophy and support bone growth?

Accepted Answer

Active vitamin D (calcitriol or alfacalcidol) combined with calcium supplementation to normalize PTH and support bone mineralization during growth

Answer

Vitamin C in megadoses

Answer

Vitamin K2 in isolation

Answer

Thiamine (vitamin B1) in megadoses

Question 5

The MOST important reason to use nasogastric or gastrostomy tube feeding in a pediatric patient with ESRD rather than relying solely on oral feeding is:

Accepted Answer

Tube feeding ensures predictable, adequate intake to meet the high caloric and nutritional requirements for normal growth and neurodevelopment when oral intake is chronically insufficient due to uremic anorexia and vomiting

Answer

Oral feeding is contraindicated in all ESRD children

Answer

Tube feeding prevents the need for dialysis

Answer

Tube feeding is preferred because oral feeding causes CKD progression

Question 6

A 10-year-old child on hemodialysis has consistent pre-dialysis potassium of 6.8 mEq/L. After reviewing their 3-day food record, which high-potassium food item is MOST commonly over-consumed in the pediatric dialysis population?

Accepted Answer

Fruit juices, sports drinks, and carbonated beverages (especially those with added potassium)

Answer

Baked potatoes and sweet potatoes

Answer

Egg whites and lean chicken

Answer

White rice and white bread