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Published on: June 16, 2014
Structured Appetite Assessment in Children With Chronic Kidney Disease
Matthew J Harmer1, Steve Wootton2, Rodney D Gilbert3
1Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre-Nutrition, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Insights
A new tool, the Modified ক্ষুধা Assessment Questionnaire (ModSNAQ), effectively assesses appetite in children with chronic kidney disease (CKD). This validated tool reveals that poor appetite is common in pediatric CKD and doesn't correlate with kidney function.
Area of Science:
- Pediatric Nephrology
- Clinical Nutrition
- Patient-Reported Outcomes
Background:
- Appetite disturbances are prevalent in pediatric chronic kidney disease (CKD).
- Current clinical practice lacks validated tools for structured appetite assessment in this population.
- This study addresses the need for a reliable method to evaluate appetite in children with CKD.
Purpose of the Study:
- To explore appetite characteristics in pediatric CKD.
- To validate a simplified, user-friendly appetite assessment tool, the Modified ক্ষুধা Assessment Questionnaire (ModSNAQ).
- To assess the relationship between appetite, dietary intake, and clinical outcomes in children with CKD.
Main Methods:
- The ModSNAQ tool underwent content validity assessment.
- An observational, cross-sectional study enrolled children with CKD.
- ModSNAQ scores were validated against dietary intake and correlated with clinical data, including 12-month growth and renal function outcomes.
Main Results:
- The ModSNAQ demonstrated excellent content validity.
- Nearly 25% of children with CKD reported poor or very poor appetite.
- ModSNAQ scores predicted adequate energy and protein intake and correlated with height, but not renal function. Poor appetite was associated with increased BMI, though changes in height and renal function at 12 months did not correlate with ModSNAQ scores.
Conclusions:
- The ModSNAQ is a validated tool for structured appetite assessment in pediatric CKD.
- Low appetite is more common in pediatric CKD than previously recognized.
- Appetite impairment in pediatric CKD does not directly correlate with the degree of renal impairment.
Objectives:
Appetite disturbances are common in children with chronic kidney disease (CKD). Although appetite assessment is recommended in clinical practice, no validated tools exist for structured evaluation. This study explores appetite in pediatric CKD and validates a simplified, user-friendly assessment tool.
Methods:
Following its construction, the ModSNAQ tool was assessed for content validity and employed in an observational cross-sectional study of children with CKD to validate it against dietary intake. The ModSNAQ scores were used to explore relationships of appetite and clinical data, including follow-up outcomes of growth and renal function at 12 months.
Results:
The tool showed excellent content validity. In the cohort of children with CKD (mean glomerular filtration rate = 52 mL/minute/1.73 m2), almost a quarter rated their appetite as poor/very poor. Although not correlating with renal function, ModSNAQ scores predicted meeting energy and protein intake and correlated with height. Change in height and renal function at 12 months did not correspond with ModSNAQ scores, but those with poor appetite had an increase in body mass index.
Conclusions:
The ModSNAQ is validated against dietary intake and offers a structured approach to appetite assessment. Using this tool, low appetite is more common than previously reported in CKD and does not correlate with degree of renal impairment.
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