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Assessment of Vascular Function in Patients With Chronic Kidney Disease

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Growth impairment and nutritional status in children with chronic kidney disease

Betul Sozeri¹, Sevgi Mir, Orhan Deniz Kara

¹Ege University, Faculty of Medicine, Department of Pediatric Nephrology, Turkey.

Iranian Journal of Pediatrics

|October 12, 2012

Insights

Growth failure and malnutrition affect nearly half of pediatric chronic kidney disease (CKD) patients. These issues are linked to patient age and treatment type, highlighting a significant clinical challenge.

Area of Science:

Pediatric Nephrology
Clinical Nutrition
Growth and Development

Background:

Malnutrition is a known complication in adult chronic kidney disease (CKD) patients, associated with adverse outcomes.
Limited data exists regarding the prevalence and impact of malnutrition and growth failure in pediatric CKD populations.

Purpose of the Study:

To determine the prevalence of growth failure and malnutrition in children with CKD.
To investigate the interrelationships between growth, malnutrition, and clinical parameters in pediatric CKD.
To explore the influence of age and therapy modalities on these nutritional and growth parameters.

Main Methods:

A cohort of 42 pediatric CKD patients was compared to 29 healthy controls.
Patients were stratified by age group and treatment modality (predialysis, hemodialysis, peritoneal dialysis).
Nutritional status was assessed using Kidney Disease Outcomes Quality Initiative guidelines, with age-adjusted reference values.

Main Results:

45% of pediatric CKD patients exhibited malnutrition.
Malnutrition was prevalent across predialysis and end-stage renal disease (ESRD) groups.
Children with ESRD showed significantly lower mean height and weight Standard Deviation Scores (SDS) compared to other groups.
Height SDS varied across different age groups, being lower in the pubertal period compared to early childhood.

Conclusions:

Growth failure and malnutrition are significant and prevalent issues in children with CKD.
The prevalence and severity of these conditions are dependent on the patient's age and the type of renal replacement therapy.
These findings underscore the need for targeted nutritional and growth monitoring in pediatric CKD management.

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Abstract

Objective:

Malnutrition is closely linked to chronic kidney disease (CKD) in adult patients with poor outcome. But data on pediatric patients is inadequate. The aim of this study was to describe the prevalence of growth failure and malnutrition in pediatric CKD patients and explore the relationship of these parameters to each other and to other clinical parameters.

Methods:

This study included 42 patients and 29 healthy children matched for age and gender. Patients were classified firstly in age group and secondly in therapy modalities. Nutritional evaluations were performed according to the Kidney Disease Outcomes Quality Initiative guidelines, and we performed adjustments using values from children with the same chronological age as reference.

Findings:

In pubertal group, the mean height SDS was lower than in pre-pubertal period while it was higher than in early childhood (P=0.4 and P=0.03 respectively). In all groups, 45% of patients had malnutrition: 20 patients on predialysis, 22 patients with end stage renal disease (14 on hemodialysis, and 8 on peritoneal dialysis). The mean weight SDS was lower in end stage renal disease groups (P<0.001). The height SDS was lower in end stage renal disease groups (P<0.001).

Conclusion:

Growth failure and malnutrition remain a significant clinical problem as age and therapy modalities are dependent in children with CKD.

Keywords:

Chronic Kidney Disease Growth Malnutrition Renal Replacement Therapy

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