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Assessment of body composition in children with chronic renal failure
F Schaefer1, E Wühl, R Feneberg
1Division of Pediatric Nephrology, Children's Hospital, University of Heidelberg, Germany. franz_schaefer@med.uni-heidelberg.de
Insights
New methods precisely assess body composition in children with chronic kidney disease. These tools monitor nutritional and fluid balance, crucial for the well-being of pediatric patients undergoing dialysis or transplantation.
Area of Science:
- Pediatric Nephrology
- Body Composition Analysis
- Nutritional Science
Background:
- Children with chronic renal failure face risks to nutritional, metabolic, and fluid homeostasis.
- Accurate body composition assessment in this group was previously challenging due to limited tools.
Purpose of the Study:
- To highlight recent advancements in body composition monitoring for pediatric chronic renal failure patients.
- To discuss the utility of new anthropometric and bioelectrical impedance methods.
Main Methods:
- Utilizing pediatric-specific body mass index (BMI) reference values with standard deviation scores.
- Employing skewness-adapted data for percentage fat mass via multisite skinfold measurements.
- Validating bioelectrical impedance analysis (BIA) in healthy children and pediatric renal populations.
Main Results:
- Pediatric BMI reference data allows for precise assessment, accounting for skewed distributions.
- Multisite skinfold measurements with adapted data improve fat mass evaluation.
- Bioelectrical impedance analysis is a validated, reproducible, non-invasive, and cost-effective method for monitoring body water, fat, and fat-free mass in pediatric renal patients.
Conclusions:
- Recent methodological advances significantly improve body composition monitoring in children with chronic renal failure.
- These tools are vital for precise assessment and management of nutritional and fluid status in pediatric dialysis and transplant patients.
Abstract:
In children with chronic renal failure treated conservatively by dialysis or by transplantation, various alterations of the nutritional, metabolic and fluid homeostasis may occur that may critically affect the patients' acute and chronic well-being. In the past, the assessment of body composition in children was hampered by insufficient precision, standardization and/or availability of appropriate anthropometric tools. Recently, there have been several methodological advances that may facilitate close and precise monitoring of body composition in this population. Specifically, the use of body mass index (BMI) data in children has become possible by the introduction of pediatric reference values processed for the calculation of standard deviation scores accounting for the skewed distribution of BMI. Skewness-adapted reference data have also been provided for percentage fat mass as assessed by multisite skinfold measurements. In addition, bioelectrical impedance analysis has been validated in healthy children as well as in pediatric dialysis and renal transplant populations. This novel auxological technique provides a highly reproducible, non-invasive and inexpensive way of assessing changes in total body water content in dialysed patients, as well as changes in fat and fat-free mass prior to dialysis and after renal transplantation.