Structured Appetite Assessment in Children With Chronic Kidney Disease

Appetite disturbances are common in children with chronic kidney disease (CKD). Although appetite assessment is recommended in clinical practice, no validated tools exist for structured evaluation. This study explores appetite in pediatric CKD and validates a simplified, user-friendly assessment tool.

Following its construction, the ModSNAQ tool was assessed for content validity and employed in an observational cross-sectional study of children with CKD to validate it against dietary intake. The ModSNAQ scores were used to explore relationships of appetite and clinical data, including follow-up outcomes of growth and renal function at 12 months.

The tool showed excellent content validity. In the cohort of children with CKD (mean glomerular filtration rate = 52 mL/minute/1.73 m²), almost a quarter rated their appetite as poor/very poor. Although not correlating with renal function, ModSNAQ scores predicted meeting energy and protein intake and correlated with height. Change in height and renal function at 12 months did not correspond with ModSNAQ scores, but those with poor appetite had an increase in body mass index.

The ModSNAQ is validated against dietary intake and offers a structured approach to appetite assessment. Using this tool, low appetite is more common than previously reported in CKD and does not correlate with degree of renal impairment.