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Children with Intestinal Failure Maintain Their Renal Function on Long-Term Parenteral Nutrition

Anat Guz Mark1,2, Shelly Levi2,3, Miriam Davidovits2,3

  • 1Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva 4920235, Israel.

Nutrients
|October 23, 2021
PubMed

Insights

Children on long-term parenteral nutrition (PN) for intestinal failure (IF) often show signs of kidney issues like hypercalciuria, but generally maintain good kidney function. Long-term monitoring is crucial for understanding PN

Area of Science:

  • Pediatric Nephrology
  • Gastroenterology
  • Clinical Nutrition

Background:

  • Long-term parenteral nutrition (PN) is linked to renal complications like hypercalciuria, nephrocalcinosis, proteinuria, and reduced glomerular filtration rate (GFR).
  • Pediatric data on long-term PN and renal outcomes are limited.
  • This study investigates renal complications in children with intestinal failure (IF) undergoing extended PN treatment.

Purpose of the Study:

  • To assess the prevalence of renal complications in pediatric patients with intestinal failure (IF) receiving long-term home parenteral nutrition (PN).
  • To evaluate kidney function, including GFR, proteinuria, and metabolic abnormalities, in this specific pediatric population.

Main Methods:

  • A cross-sectional study was conducted in a tertiary pediatric IF clinic.
  • Data were collected from patients receiving home PN for over one year.
  • Included medical history, anthropometrics, laboratory results, and abdominal sonography.

Main Results:

  • 15 children with a median PN duration of 4 years were analyzed.
  • Proteinuria (61%) and microalbuminuria (30%) were common.
  • Hypercalciuria (50%) and hyperoxaluria (46%) were prevalent.
  • Nephrocalcinosis was observed in only one patient; GFR was preserved in most.

Conclusions:

  • Pediatric IF patients can maintain preserved kidney function despite years of PN.
  • While hypercalciuria is frequent, nephrocalcinosis is not a common complication.
  • Baseline and ongoing renal function monitoring are essential for managing long-term PN effects in children.
Abstract

Keywords:
calciuriacomplicationsfollow upkidneyproteinuriatotal parenteral nutrition

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