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Nutritional status of children undergoing continuous ambulatory peritoneal dialysis
Insights
Children undergoing continuous ambulatory peritoneal dialysis (CAPD) show poor nutritional status and reduced stature. Nutritional intake and protein losses during dialysis contribute to these concerning findings in pediatric patients.
Area of Science:
- Pediatric Nephrology
- Nutritional Science
- Clinical Medicine
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for children with kidney failure.
- Nutritional status is crucial for growth and development in pediatric patients undergoing long-term dialysis.
- Previous studies have indicated potential nutritional challenges in children on CAPD.
Purpose of the Study:
- To assess the nutritional status of clinically stable children undergoing CAPD.
- To identify specific nutritional parameters affected by CAPD in pediatric patients.
- To compare nutritional status between younger (<10 years) and older (≥10 years) children on CAPD.
Main Methods:
- Nutritional status was evaluated in 24 children on CAPD.
- Anthropometric measurements (height, weight, midarm circumference, triceps skinfold) were taken.
- Biochemical markers (serum total protein, albumin, transferrin, amino acids, triglycerides, cholesterol) were analyzed.
- Nutritional intake (energy, protein) was assessed.
Main Results:
- Children on CAPD exhibited reduced height, weight, and muscle circumference compared to normal peers.
- Height retardation was particularly severe in younger children.
- Serum protein, albumin, transferrin, and amino acids were decreased; triglycerides and cholesterol were elevated.
- Energy intake was more suppressed than protein intake.
Conclusions:
- Children undergoing CAPD demonstrate significantly impaired nutritional status and decreased stature.
- Low nutrient intake and protein losses through dialysate likely contribute to these abnormalities.
- Age appears to influence the severity of certain nutritional deficits in pediatric CAPD patients.
Abstract:
Nutritional status was assessed in 24 clinically stable children, aged 9.68 +/- 4.31 (SD) yr, who underwent CAPD for 6.6 +/- 4.4 months. Energy intake tended to be more suppressed than protein intake. Several nutritional parameters were more abnormal in children less than 10 yr old as compared to children 10 yr of age or older. In comparison to normals of the same chronological age and sex, both groups of patients displayed reduced height, weight, midarm, and midarm muscle circumference, and, in the younger children, triceps skinfold; height retardation was particularly severe. Compared to height/age, anthropometry was not reduced in older children while triceps skinfold and midarm circumference were decreased in children younger than 10 yr. In both groups, serum total protein, albumin, transferrin, and many plasma amino acids were decreased, and serum triglycerides and cholesterol were elevated. Serum total protein decreased during treatment with continuous ambulatory peritoneal dialysis. These observations suggest decreased stature and poor nutritional status in children undergoing continuous ambulatory peritoneal dialysis. Low protein and energy intake and dialysate protein losses may contribute to these abnormalities.