Nutritional intake in children with renal insufficiency: a report of the growth failure in children with renal diseases study.

Foreman, John W.; Abitbol, Carolyn; Trachtman, Howard; Garin, Eduardo H.; Feld, Leonard G.; Strife, C. Frederic; Massie, Martha D.; Boyle, R. M.; Chan, James C.M.

doi:10.1080/07315724.1996.10718633

Cited by 61 publications

(30 citation statements)

References 16 publications

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“…Proteinenergy malnutrition may be a mechanism for growth restriction and LM wasting among children with CKD. 23 However, outside infancy, energy intake among children with CKD is generally appropriate for body size, 15 and protein intake has been reported to be 1.5 to 2 times that recommended. 15,23,42 Accumulating evidence suggests that LM wasting in CKD is unrelated to protein-calorie intake; rather, systemic inflammation, acidosis, growth hormone resistance, and disturbances in neuropeptide signaling have been proposed as important mediators of muscle wasting.…”

Section: Discussionmentioning

confidence: 99%

“…23 However, outside infancy, energy intake among children with CKD is generally appropriate for body size, 15 and protein intake has been reported to be 1.5 to 2 times that recommended. 15,23,42 Accumulating evidence suggests that LM wasting in CKD is unrelated to protein-calorie intake; rather, systemic inflammation, acidosis, growth hormone resistance, and disturbances in neuropeptide signaling have been proposed as important mediators of muscle wasting. 34,[43][44][45][46][47][48] Furthermore, other nutritional indicators such as FM Z-scores indicated that our CKD participants likely had adequate energy intake.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…In view of the considerable strength in biostatistics at this medical school and long-standing collaboration on clinical trials [28, 29], we have been able to transfer to patient care what we learned on the laboratory bench on the antioxidants’ role in tissue healing. When the NIH issued a ‘Request for Applications’ to study IgA nephropathy, our team of in-house clinical/biostatistical/pharmacy collaborators quickly designed a double-blinded study on the use of an antioxidant to reduce oxidative injury.…”

Section: Strategy To Meet Challenge Of Researchmentioning

confidence: 99%

“…For a program under the same leadership for 20 years, there is a real danger of complacency and inbreeding. The external reviewers and collaborators [28, 29], the external sabbaticals for the faculty, and the constant influx of new trainees and new faculty from outside this institution are essential to give us a fresh outlook.…”

Section: Strategy To Meet Challenge Of Researchmentioning

confidence: 99%

Lessons from 20 Years of Leading a Pediatric Nephrology Program

Chan

1998

Nephron

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The patterns of patient referrals, the guidelines for diagnostic procedures and treatment, and the academic leadership have continued to change in the last two decades. The revolution brought about by molecular biology has dramatically changed the pace and direction of medical research during this period. In addition, the introduction of managed care competition in the past decade has dramatically challenged the practice of medicine. The effects of all these changes on nephrology and some lessons learned from developing and leading a regional pediatric nephrology program will be discussed. The role of the National Institutes of Health in changing research focus will be examined. These observations may be useful to those preparing to meet the challenges of clinical care and research in this competitive era.

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“…Deficiency of micronutrients like vitamins, iron, zinc and copper are the most important reasons for immunodeficiency (Foreman et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

Copper and Zinc Serum Level in Patients Receiving Hemodialysis

Raoofi¹,

Hakimelahi²,

Sanie³

et al. 2015

OnLine Journal of Biological Sciences

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Decreased kidney function can accumulate trace elements. Increased trace elements can have toxic features. On the other hand, studies are showing that concentration of some trace elements could be decreased in chronic kidney disease patients as well. Because these patients are at risk for alterations of trace elements, we measured serum level of zinc and copper trace elements in hemodialysis patients and compare it with the control group. We analyzed the trace elements' copper and zinc concentration in the whole blood of 52 ESRD patients who were treated with hemodialysis as case group and also of 52 age and sex matched healthy people as control group. Whole blood trace element concentration was determined by atomic absorption spectrometry. The serum concentrations of zinc and copper were significantly lower in case group compared to control group. The serum concentration of zinc and copper trace elements in end-stage renal failure patients is disturbed. Due to the discrepancy in findings of different studies, further studies in large scale are recommended to determine the serum concentration of trace elements in these patients.

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Nutritional intake in children with renal insufficiency: a report of the growth failure in children with renal diseases study.

Cited by 61 publications

References 16 publications

Association of Chronic Kidney Disease with Muscle Deficits in Children

Association of Chronic Kidney Disease with Muscle Deficits in Children

Lessons from 20 Years of Leading a Pediatric Nephrology Program

Copper and Zinc Serum Level in Patients Receiving Hemodialysis

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