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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
[A retrospective study on nutritional status and growth and development of 37 children with chronic kidney disease
1Department of Nephrology, Children's Hospital Affiliated to the Capital Institute of Pediatrics, Beijing 100020, China.
Insights
Growth retardation is common in children with chronic kidney disease (CKD) stages 3-5, worsening with disease progression. Nutritional status varies, with both underweight and obesity observed, and hypertriglyceridemia being prevalent.
Area of Science:
- Pediatric Nephrology
- Nutritional Science
- Growth and Development Studies
Background:
- Chronic kidney disease (CKD) in children significantly impacts overall health.
- Nutritional status and growth are critical indicators in pediatric CKD management.
- Understanding these factors at diagnosis is essential for timely intervention.
Purpose of the Study:
- To assess the nutritional status and growth/development of children diagnosed with CKD stages 3-5.
- To identify the prevalence of growth retardation, malnutrition, and metabolic abnormalities at initial diagnosis.
Main Methods:
- Retrospective analysis of 37 pediatric patients with CKD stages 3-5.
- Data collected included anthropometrics (height, weight, BMI), serum albumin, blood lipids, and acid-base status.
- Statistical analysis of nutritional and developmental parameters based on CKD stage.
Main Results:
- High prevalence of growth retardation: 62% shorter than the third percentile, 49% lower weight.
- Abnormal lipid profiles were common, with hypertriglyceridemia (62%) being the most frequent.
- Metabolic acidosis was more severe in stage 5 CKD (69%) compared to stages 3-4 (38%).
Conclusions:
- Growth retardation is highly prevalent in pediatric CKD stages 3-5 and worsens with disease progression.
- Nutritional status is complex, with both underweight and obesity present; low albumin is not a sensitive malnutrition marker.
- Hypertriglyceridemia is the most common lipid abnormality, and severe metabolic acidosis is more frequent in advanced CKD stages.
Objective:
To retrospectively analyze the nutritional status and growth and development situation of the children with chronic kidney disease stage 3 to 5 when they were diagnosed at the first visit.
Method:
After searching for the data of all the hospitalized cases during January 2007 to September 2015 in the Department of Nephrology of Children's Hospital Affiliated to the Capital Institute of Pediatrics from the medical record system, data of 37 cases with complete clinical data were collected; all these cases were diagnosed as chronic kidney disease stage 3 to 5 according to the diagnostic criteria.We recorded these children's age, height, weight, body mass index, albumin, blood lipids and acidosis situation when they were first diagnosed, and then, analyzed and summarized their nutritional status and growth and development situation.
Result:
In these 37 cases, 24 cases were boys and 13 cases were girls; 23 cases (62%) were shorter than the third percentile of age-sex-specific height; 18 cases (49%) exhibited lower weight than the third percentile of age-sex-specific weight; 5 cases (13.5%) showed lower BMI than the third percentile of height-age BMI, and 5 cases (13.5%) had obesity. The level of albumin was (37.0±8.7) g/L, and no statistically significant difference was observed within each stage. In all of these cases, 10 cases were hypoalbuminemia (27%), and the difference of its frequency between stage 3-4 and stage 5 was not statistically significant. Triglyceride was (2.2±1.1) mmol/L. The mean level was higher than the normal range, but with no statistically significant difference within each stage; 21 cases (62%) were diagnosed as hypertriglyceridemia, which were more frequent compared with the occurrence of the hypercholesterolemia (32%), the high low density lipoprotein (26%) and the low high density lipoprotein(12%). And the occurrence of decompensated metabolic acidosis in stage 5 (69%) was significantly higher than that in stage 3-4 (38%) (P=0.036 6, <0.05).
Conclusion:
Growth retardation is highly prevalent among the children with chronic kidney disease stage 3 to 5. It would become more frequent and more serious as the stage worsening. Both underweight and obesity could be observed in this kind of children. Low serum albumin level is not a sensitive indicator of malnutrition in these children. The mean value of triglyceride in the children with chronic kidney disease was higher than the normal range. And hypertriglyceridemia is the most common abnormal lipid metabolism in our study.
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