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Nutritional status and clinical outcome of children on continuous renal replacement therapy: a prospective

Ana Castillo1, Maria J Santiago, Jesús López-Herce

  • 1Pediatric Intensive Care Department Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.

BMC Nephrology
|September 29, 2012
PubMed

Insights

Malnutrition, or protein-energy wasting, is common in critically ill children undergoing continuous renal replacement therapy (CRRT). This condition significantly increases their risk of mortality.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Nutritional Science

Background:

  • Nutritional status in pediatric patients receiving continuous renal replacement therapy (CRRT) remains understudied.
  • Assessing the link between nutritional status and mortality in these children is crucial.

Purpose of the Study:

  • To evaluate the association between nutritional status and mortality in children undergoing CRRT.
  • To identify nutritional parameters linked to adverse outcomes in pediatric CRRT patients.

Main Methods:

  • A prospective observational study was conducted on 174 critically ill children receiving CRRT.
  • Data collected included demographics, clinical diagnoses, nutritional markers (albumin, creatinine, weight-for-age percentiles), illness severity scores, and mortality.
  • Statistical analyses, including logistic regression, were used to determine associations.

Main Results:

  • 35% of children were underweight (below P3), and 56% had a weight/P50 ratio < 0.85; obesity was rare.
  • Protein-energy wasting was significantly associated with higher mortality (OR, 2.11; p = 0.032).
  • Underweight children (< P3) exhibited a higher mortality rate (51%) compared to normal weight children (33%; p = 0.037).

Conclusions:

  • Protein-energy wasting is highly prevalent in children requiring CRRT, unlike obesity.
  • Children with prior end-stage renal disease or heart conditions showed higher rates of protein-energy wasting.
  • Underweight status in pediatric CRRT patients is a significant predictor of increased mortality.
Abstract

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