Growth and body composition in children with chronic kidney disease

Rashid, Rajeeb; Neill, Esther; Maxwell, Heather; Ahmed, S Faisal

doi:10.1017/s0007114507252675

Cited by 12 publications

(8 citation statements)

References 90 publications

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“…Unlike some studies, which reported elevated adiposity in CKD, 33 we observed significantly elevated whole body FM Zscores only among CKD 4 to 5 participants. However, our findings regarding fat distribution were consistent with prior reports, indicating central distribution of adiposity in both children 12 and adults 20 with CKD.…”

Section: Discussioncontrasting

confidence: 99%

Association of Chronic Kidney Disease with Muscle Deficits in Children

Foster

Kalkwarf²,

Shults³

et al. 2011

Journal of the American Society of Nephrology

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The effect of chronic kidney disease (CKD) on muscle mass in children, independent of poor growth and delayed maturation, is not well understood. We sought to characterize whole body and regional lean mass (LM) and fat mass (FM) in children and adolescents with CKD and to identify correlates of LM deficits in CKD. We estimated LM and FM from dual energy x-ray absorptiometry scans in 143 children with CKD and 958 controls at two pediatric centers. We expressed whole body, trunk, and leg values of LM and FM as Z-scores relative to height, sitting height, and leg length, respectively, using the controls as the reference. We used multivariable regression models to compare Z-scores in CKD and controls, adjusted for age and maturation, and to identify correlates of LM Z-scores in CKD. Greater CKD severity associated with greater leg LM deficits. Compared with controls, leg LM Z-scores were similar in CKD stages 2 to 3 (difference: 0.02 [95% CI: Ϫ0.20, 0.24]; P ϭ 0.8), but were lower in CKD stages 4 to 5 (Ϫ0.41 [Ϫ0.66, Ϫ0.15]; P ϭ 0.002) and dialysis (Ϫ1.03 [Ϫ1.33, Ϫ0.74]; P Ͻ 0.0001). Among CKD participants, growth hormone therapy associated with greater leg LM Z-score (0.58 [0.03, 1.13]; P ϭ 0.04), adjusted for CKD severity. Serum albumin, bicarbonate, and markers of inflammation did not associate with LM Z-scores. CKD associated with greater trunk LM and FM, variable whole body LM, and normal leg FM, compared with controls. In conclusion, advanced CKD associates with significant deficits in leg lean mass, indicating skeletal muscle wasting. These data call for prospective studies of interventions to improve muscle mass among children with CKD.

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Section: Discussioncontrasting

confidence: 99%

Association of Chronic Kidney Disease with Muscle Deficits in Children

Foster

Kalkwarf²,

Shults³

et al. 2011

Journal of the American Society of Nephrology

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“…Previously, we showed that AgRP attenuated cachexia in CKD mice (8,10). Although promising, our previous studies (38,39) with AgRP have one major caveat, as we used dual energy X-ray absorptiometry (DXA) to assess the body composition in mice. DXA cannot measure body water.…”

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confidence: 99%

Melanocortin antagonism ameliorates muscle wasting and inflammation in chronic kidney disease

Cheung

Mak

2012

American Journal of Physiology-Renal Physiology

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Aberrant melanocortin signaling has been implicated in the pathogenesis of wasting in chronic kidney disease (CKD). Previously, we demonstrated that agouti-related peptide (AgRP), a melenocortin-4 receptor antagonist, reduced CKD-associated cachexia in CKD mice. Our previous studies with AgRP utilized dual energy X-ray (DXA) densitometry to assess the body composition in mice (Cheung W, Kuo HJ, Markison S, Chen C, Foster AC, Marks DL, Mak RH. J Am Soc Nephrol 18: 2517–2524, 2007; Cheung W, Yu PX, Little BM, Cone RD, Marks DL, Mak RH. J Clin Invest 115: 1659–1665, 2005). DXA is unable to differentiate water content in mice, and fluid retention in CKD may lead to an overestimate of lean mass. In this study, we employed quantitative magnetic resonance technique to evaluate body composition change following central administration of AgRP in a CKD mouse model. AgRP treatment improved energy expenditure, total body mass, fat mass, and lean body mass in CKD mouse. We also investigated the effect of CKD-associated cachexia on the signaling pathways leading to wasting in skeletal muscle, as well as whether these changes can be ameliorated by central administration of AgRP. AgRP treatment caused an overall decrease in proinflammatory cytokines, which may be one important mechanism of its effects. Muscle wasting in CKD may be due to the activation of proteolytic pathways as well as inhibition of myogenesis and muscle regeneration processes. Our results suggest that these aberrant pathological pathways leading to muscle wasting in CKD mice were ameliorated by central administration of AgRP.

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“…Causes of growth failure include in CKD disturbances in growth hormone (GH) metabolism and insulin-like growth factor-I (IGF-I), electrolyte abnormalities, nutritional deficiency, metabolic acidosis, uremia, anemia, and inflammation ( 2 , 16 , 17 , 21 – 23 ). Other hormonal changes in CKD that adversely affect growth include vitamin D deficiency, hyperparathyroidism, and hypogonadism ( 24 – 26 ).…”

Section: Causes Of Growth Impairment In Ckdmentioning

confidence: 99%

“…The prevalence of ESRD is about nine per one million children in the United States, with the highest incidence of new patients with ESRD appearing in early and mid-adolescence ( 1 ). Despite advances in the diagnosis and care of children with CKD, many will progress to ESRD ( 2 ). Growth failure is a major complication of CKD.…”

Section: Introductionmentioning

confidence: 99%

Growth and Nutrition in Pediatric Chronic Kidney Disease

Silverstein

2018

Front. Pediatr.

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Children with chronic kidney disease (CKD) feature significant challenges to the maintenance of adequate nutrition and linear growth. Moreover, the impaired nutritional state contributes directly to poor growth. Therefore, it is necessary to consider nutritional status in the assessment of etiology and treatment of sub-optimal linear growth. The major causes of poor linear growth including dysregulation of the growth hormone/insulin-like growth factor-I (IGF-I) axis, nutritional deficiency, metabolic acidosis, anemia, renal osteodystrophy/bone mineral disease, and inflammation. This review summarizes the causes and assessment tools of growth and nutrition while providing a summary of state of the art therapies for these co-morbidities of pediatric CKD.

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Growth and body composition in children with chronic kidney disease

Cited by 12 publications

References 90 publications

Association of Chronic Kidney Disease with Muscle Deficits in Children

Association of Chronic Kidney Disease with Muscle Deficits in Children

Melanocortin antagonism ameliorates muscle wasting and inflammation in chronic kidney disease

Growth and Nutrition in Pediatric Chronic Kidney Disease

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