Nutritional assessment (registered dietitian) |
Height, weight, ideal weight for stature, growth velocity, BMI when appropriate |
Head circumference in infants |
Review appropriateness of KDT prescription (calories, protein, and fluid) |
Review vitamin and mineral supplementation |
Assess compliance to KDT |
Adjust KDT if necessary to improve compliance and seizure control |
Medical evaluation (neurologist) |
Efficacy of the diet (is the KDT meeting parental expectations?) |
Side effects of KDT |
Antiseizure medication reduction (if applicable) |
Should KDT be continued? |
Laboratory assessment |
Complete blood count with platelets |
Electrolytes to include serum bicarbonate, total protein, calcium |
Serum liver and kidney profile (including albumin, blood urea nitrogen, creatinine) |
Vitamin D level |
Fasting lipid profile |
Free and total carnitine |
Urinalysis |
Selenium level |
Antiseizure medication levels (if applicable) |
EEG (at KDT discontinuation consideration) |
Optional |
Serum beta-hydroxybutyrate (BOH) level |
Urine calcium and creatinine |
Zinc, copper levels |
Renal ultrasound |
ECG |
Bone mineral density (DEXA scan) after 2 years on the KD |
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