Document Type

Article

Publication Date

10-2025

Identifier

DOI: 10.1007/s00467-025-06759-5; PMCID: PMC12402044

Abstract

Children and young people with chronic kidney disease (CKD) are at risk for deficiency or excess of magnesium and trace elements. Kidney function, dialysis, medication, and dietary and supplemental intake can affect their biochemical status. There is much uncertainty about the requirements of magnesium and trace elements in CKD, which leads to variation in practice. The Pediatric Renal Nutrition Taskforce is an international team of pediatric kidney dietitians and pediatric nephrologists, formed to develop evidence-based clinical practice points to improve the nutritional care of children with CKD. PICO (patient, intervention, comparator, and outcomes) questions led the literature searches, which were conducted to ascertain current biochemical status, dietary intake, and factors leading to requirements differing from healthy peers, and to guide nutritional care of children with CKD stages 2-5, on dialysis, and post-transplantation. We address the assessment and intervention of magnesium and the trace elements chromium, copper, fluoride, iodine, manganese, selenium, and zinc. We suggest routine biochemical assessment of magnesium. Trace element assessment is based on clinical suspicion of deficiency or excess and their risk factors, including accumulation, losses, medications, nutrient interactions, and comorbidities. In particular, we suggest assessing magnesium, copper, iodine, and zinc when growth is poor, and evaluating magnesium, copper, selenium, and zinc in the presence of proteinuria. A structured approach to magnesium and trace element management, including biochemical, physical, and dietary assessment, is beneficial in the paucity of evidence. Research recommendations are suggested.

Journal Title

Pediatric nephrology (Berlin, Germany)

Volume

40

Issue

10

First Page

3301

Last Page

3323

MeSH Keywords

Humans; Trace Elements; Magnesium; Child; Renal Dialysis; Kidney Transplantation; Renal Insufficiency, Chronic; Nutritional Status; Magnesium Deficiency; Dietary Supplements; Adolescent

PubMed ID

40379985

Keywords

Children; Chronic kidney disease; Clinical practice points; Magnesium; Minerals; Pediatric Renal Nutrition Taskforce; Trace elements

Comments

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Publisher's Link: https://link.springer.com/article/10.1007/s00467-025-06759-5

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