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[Nitrogen balance in adolescent patients with chronic renal insufficiency]
R A Lama More1, A Alonso Melgar, M Navarro Torres
1Servicio de Nefrología Pediátrica, Hospital Universitario Materno Infantil La Paz, Universidad Autónoma de Madrid, España.
Insights
Protein restriction in children with chronic kidney disease (CKD) can negatively impact nitrogen balance, especially in adolescents. Careful monitoring of energy and protein intake is crucial for managing pediatric CKD patients.
Area of Science:
- Pediatric Nephrology
- Nutritional Science
- Metabolic Balance Studies
Context:
- Chronic renal failure (CRF) in children presents unique nutritional challenges.
- Protein restriction is a debated intervention in pediatric chronic kidney disease (CKD).
- Understanding nitrogen balance is key to assessing nutritional status in growing children with CKD.
Purpose:
- To evaluate nitrogen balance in preadolescent and adolescent children with chronic renal failure.
- To determine the correlation between energy/protein intake and nitrogen balance in pediatric CKD.
- To assess the relationship between renal function (GFR) and nitrogen balance.
Summary:
- Nitrogen balance was assessed in 60 children (36 preadolescents, 24 adolescents) with CKD (GFR ~53 ml/min/1.73 m2).
- 55% of all patients exhibited negative nitrogen balance.
- Preadolescents showed a higher incidence of positive nitrogen balance (72%) compared to adolescents (17%).
- A strong correlation existed between energy and protein intake and nitrogen balance, independent of renal function.
- Adolescents predominantly presented with negative nitrogen balance.
Impact:
- Highlights the risk of negative nitrogen balance with protein restriction in pediatric CKD.
- Suggests that adolescents with CKD may have different protein requirements than preadolescents.
- Underscores the need for further protein turnover studies to establish optimal nutritional guidelines for pediatric CKD.
- Informs clinical practice regarding nutritional management in growing children with kidney disease.
Unlabelled:
Protein restriction in patients with chronic renal failure may be potentially beneficial, however the dangers in growing children of such restrictions must be considered. We analyzed the nitrogen balance in 60 chronic renal failure children (47 male y 13 female) Group A: 36 preadolescents. GFR was 54.5 +/- 25.6 ml/min/1.73 m2. Group B: 24 adolescents. GFR 52.7 +/- 25.4 ml/min/1.73 m2.
Results:
55% of patients had a negative balance. 72% preadolescents and 17% of adolescents had positive nitrogen balance A good correlation was found between the range of energy and protein intake and nitrogen balance.
Conclusions:
1. A good correlation was found between nitrogen balance and the range of energy and protein intake but no correlation with the renal function degree. 2. Adolescents had nitrogen balance negative. 3. It is necessary turn-over protein studies in this patients to know the requirements in children with chronic renal failure.