BACKGROUND Glomerular function or kidney function can be affected because of infection or wrong diet (imbalanced nutrients) which is most of the times seen in under nourished or obese children. Like many other organs, kidney also develops in early childhood, especially up to eighteen to twenty four months of life. Malnutrition also is common in six months to two years of life. So, glomerular filtration rate can be affected in this period of life. Malnutrition mostly occurs in low-and middle-income countries. Malnutrition refers to deficiencies, excesses or imbalance in a person's energy and nutrient intake. Nutrition is one of the most important factors that determines growth and size of the human body in childhood. Malnutrition has effect both on renal growth and function of the kidneys. Kidneys serve the excretory and synthetic functions and are important for maintaining the normal homeostasis. We wanted to study the GFR in malnourished children especially who are under nourished as per World Health Organization (WHO) criteria. METHODS72 malnourished children (WHO classification) who met the inclusion criteria were included in this study from June 2017 to May 2018 after taking approval from institutional ethics committee in the department of Paediatrics, Assam Medical College & Hospital. Detailed anthropometric measurements were taken and grading of malnutrition was done according to WHO classification. Serum creatinine was measured for each case. RESULTSMajority of children (68.06%) had severe malnutrition. GFR was normal in 35 (48.61%) cases, decreased in 33 (45.83%) cases, increases in 4 (5.56 %) cases. CONCLUSIONSFrom the study, we can say that approximately 45 % patients having low glomerular filtration rate are malnourished-children, who are under nourished as per World Health Organization (WHO) criteria; but differences in GFR between male and female, and between moderate and severe malnutrition were insignificant (p>0.05).

BACKGROUND Malnutrition involves hundreds of millions of children in the developing world. Malnutrition and infection is a vicious cycle. Malnourished children suffer from many infections like respiratory tract infection, UTI, diarrhoea. UTI is more common in malnourished children, and risk of UTI is related to severity of malnutrition. Severe acute malnutrition (SAM) is associated with immune deficiency, because of which they are more vulnerable to severe infection. Risk factors for urinary tract infection include female gender, uncircumcised male, vesicoureteral reflux, poor toilet training, voiding dysfunction, obstructive uropathy, urethral instrumentation, wiping from back to front in girls, bubble bath, tight clothing (underwear), pinworm infestation, constipation, sexually activity, neuropathy bladder, anatomic abnormality (labial adhesion), bacteria with P fimbriae and under nutrition. Urinary tract infection (UTI) is more common in malnourished children, and risk of UTI is related to severity of malnutrition. Severe acute malnutrition (SAM) is associated with immunodeficiency, for which they are more vulnerable to severe infection. We wanted to study the prevalence of UTI in malnourished children. METHODS 72 malnourished children (WHO classification) who met the inclusion criteria were included in this study from June 2017 to Ma y 2018. Detailed anthropometric measurements were done and grading of malnutrition was done according to WHO classification. Urine for routine examination and culture and sensitivity was done for each case. Early morning urine was collected. In children below 3 years of age urine was collected by catheterization and in toilet trained children (> 3 years of age) midstream clean catch urine sample under strict asepsis was collected in a sterile container. After collecting urine sample was sent within one hour to the laboratory. RESULTS UTI was found in 16.67% cases, mostly in female and more frequently in 6-12 months age group and most common organisms was gram negative bacilli. CONCLUSIONS Among the various risk factors of urinary tract infection, malnutrition especially under-nutrition itself is a risk factor for UTI or sometimes urinary tract infection also can lead to malnutrition. UTI is common in malnourished children and most common causative organisms are gram negative bacilli.

BACKGROUND Malnourished children can suffer from various problems including sepsis, pneumonia, tuberculosis, gastroenteritis, vitamin A deficiency and very significantly growth failure. Malnutrition is a leading cause of stunting in under five years group of children in developing world. As stunting is visible but other parameters may remain unrecognized because of low importance in a busy paediatric ward or outpatient department (OPD) management activities. It includes growth of many organs including kidney. Under-nutrition affects more than several lakhs of children in the underdeveloped world like India. Among various factors which determine growth, nutrition is one of the most important factors that determine growth and size of the human body in childhood. Malnutrition can affect both renal growth and function of the kidney especially if it is seen in the first eighteen months of life as growth of nephron continues till two years of life though the formation of nephron is almost complete by term pregnancy. We wanted to study the size of kidney in malnourished children. METHODS In the study, 72 under nourished children were included as per inclusion criteria (according to WHO classification of malnutrition) from 01.06.2017 to 31.05.2018. Detailed anthropometric measurements were done and ultrasound kidney, ureter and bladder (KUB) was done for each case. RESULTS It has been seen that maximum number of children (68.06%) had severe malnutrition. Decreased kidney size was found in 34 (47.22%) cases. It was found that there was significant difference in kidney size between moderate and severe malnutrition (p=0.003). Significantly, there was no major difference in kidney parameters (length and width) between male and female as p value > 0.05. All measurements of right kidney were found to be lower than those of the left kidney, but no significant difference was found in size between right and left kidney. CONCLUSIONS There was no significant difference of kidney size between male and female (p>0.05). But there was significant difference of kidney parameters between severe and moderate malnutrition (p<0.05) and kidney size is best correlated with their length/height (r=0.5686). Hence it is always to be remembered that severity of malnutrition can affect the growth of kidney especially in under-five children which may have a connection to some of the chronic morbid conditions like hypertension, chronic kidney disease and end stage renal disease in later part of life.