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Growth, development and nutritional status in Japanese children under 2 years on continuous ambulatory peritoneal
M Honda1, Y Kamiyama, K Kawamura
1Department of Paediatric Nephrology, Tokyo Metropolitan Children's Hospital, Japan.
Insights
Continuous ambulatory peritoneal dialysis (CAPD) in young children showed minimal growth and developmental delays. Ensuring adequate nutritional intake is crucial for optimal outcomes in children undergoing CAPD therapy.
Area of Science:
- Pediatric Nephrology
- Growth and Development
- Nutritional Science
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment option for young children with kidney conditions.
- Long-term effects of CAPD on growth, development, and nutritional status in pre-schoolers require thorough investigation.
Purpose of the Study:
- To evaluate the 10-year growth, development, and nutritional status of 15 children under 2 years old undergoing CAPD.
- To identify correlations between nutritional intake and growth/developmental outcomes in pediatric CAPD patients.
Main Methods:
- Longitudinal study over 10 years assessing height, weight, head circumference, development quotient (DQ), blood chemistry, and dietary intake.
- Calculation of height standard deviation score (SDS) and growth velocity index (GVI).
- Correlation analysis between nutritional intake (energy, protein) and developmental markers (DQ, IQ).
Main Results:
- Mean height SDS remained stable, indicating minimal growth delay during CAPD.
- Growth velocity index (GVI) positively correlated with energy intake but not protein intake.
- Developmental quotient (DQ) was initially low but showed slight improvement; however, IQ at 5-6 years was normal in most patients, irrespective of DQ, unless cerebral disease was present.
Conclusions:
- CAPD therapy in young children is associated with minimal delays in physical growth and cognitive development.
- Adequate nutritional intake, particularly energy, is essential to support growth and development in children on CAPD.
- While initial developmental quotients may be low, long-term cognitive outcomes (IQ) appear favorable in the absence of underlying cerebral pathology.
Abstract:
We examined the growth, development and nutritional status over a period of 10 years of 15 young children (< 2 years old) on continuous ambulatory peritoneal dialysis (CAPD). There were 6 males and 9 females with a mean age of 12.5 months, mean weight of 6.3 kg, mean height of 66.2 cm at the start of CAPD and a mean duration of therapy of 2.6 years. Height, weight, head circumference, development quotient (DQ), blood chemistry and dietary intake were assessed over a period of 10 years. The patients' mean height standard deviation score (SDS) did not change significantly (from -2.51 to -2.74) during CAPD therapy. The mean growth velocity index (GVI) during CAPD was 76.5% and correlated positively with energy intake but not with protein intake. The mean DQ was low (67.0%) at the start of CAPD and 69.3% at the end of CAPD. DQ did not correlate with energy intake, GVI, head circumference SDS or with the weight/height ratio; however, 2 patients with low DQ (< 60%) had a low energy intakes. Although most patients had a low DQ, the IQ at 5-6 years of age was normal in all patients except 1 without cerebral disease. Our study showed minimal growth (delta SDS) and mental developmental (IQ) delays during CAPD therapy, but an adequate nutritional intake must be assured to obtain the above results.