Metabolic and nutritional factors in children with renal insufficiency

Uremia is associated with a decrease in muscle and adipose tissue mass and a low weight-for-height ratio. These findings are related to dietary deficiencies in uremia--particularly energy deficiency and to metabolic disorders characteristic of uremia. These latter have features of an exaggerated catabolic state which may be modified by other stresses, e.g. short starvation or high-protein diets. Recommendations for diet therapy for children with uremia are of limited value because of the lack of definitive studies. At present, diet should be adequate in energy to improve nitrogen balance and weight gain commensurate with age. There may be advantages to using a protein:energy ratio in the diet that is lower than the ratio used in conventional diets.