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Published on: July 3, 2013
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[Nutrition in children with continuous renal replacement therapy]
Maria José Santiago Lozano1, Cristina Alonso Álvarez1, Caterina Álvarez Heidbüchel1
1Servicio de Cuidados Intensivos Pediátricos, Departamento de Salud Pública y Maternoinfantil, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Red de Salud Maternoinfantil y del Desarrollo, Madrid, España.
Anales De Pediatria
|November 18, 2019
Summary
Children on continuous renal replacement therapy (CRRT) often experience undernutrition. While most tolerate enteral nutrition well, gastrointestinal issues can necessitate its discontinuation.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Nutritional Science
Background:
- Children requiring continuous renal replacement therapy (CRRT) face significant nutritional challenges.
- Assessing nutritional status and gastrointestinal (GI) complications is crucial for this vulnerable population.
Purpose of the Study:
- To analyze the nutritional state, diet, and GI complications in children undergoing CRRT.
- To evaluate the tolerance and impact of enteral nutrition in pediatric CRRT patients.
Main Methods:
- Retrospective analysis of a database of pediatric patients treated with CRRT between 2013 and 2017.
- Data collected included nutritional intake (calories, protein), type of nutrition, GI complications, and clinical course.
Main Results:
- 65 children received CRRT; 37% also required ECMO support.
- Nearly half of patients were undernourished (weight/height < P3).
- Enteral nutrition use increased from 47.7% to 80% during CRRT, with transpyloric tubes used in 76% of cases. Median intake was 63 kcal/kg/day and 1.6 g/kg/day protein.
- 73.8% experienced GI complications (gastric distension, constipation, vomiting), but only 4.6% required enteral nutrition cessation. No link found between complications and diet type or ECMO.
Conclusions:
- Children on CRRT frequently present with undernutrition.
- Despite a high incidence of GI complications, enteral nutrition is generally well-tolerated.
- GI issues, though infrequent, can be a reason for stopping enteral feeding in pediatric CRRT patients.
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