Nutritional status of children with moderate chronic renal failure

Abstract

Nutritional status was evaluated in 15 children (11 males) with moderate chronic renal failure (CRF). Two 3-day prospective dietary records, anthropometric measures and biochemical determinations were performed 3 months apart. Energy, protein, carbohydrate, fat, polyunsaturated, monounsaturated and saturated fatty acid intakes, expressed as percentages of international recommendations, were 87 +/- 14, 223 +/- 42, 73 +/- 12, 110 +/- 27, 55 +/- 31, 129 +/- 51 and 111 +/- 26%, respectively. The relative distribution of calories was 15 +/- 2% from proteins, 48 +/- 5% from carbohydrates and 37 +/- 5% from lipids. Anthropometric indices, expressed as standard deviation score, were: weight -0.50 +/- 0.8, height -0.94 +/- 1.3, growth velocity -0.61 +/- 1.8, triceps skinfold thickness -0.30 +/- 0.6, subscapular skinfold thickness -0.19 +/- 0.8, mid-arm muscle circumference 0.38 +/- 0.3 and body mass index -0.22 +/- 1.0. Serum concentrations of albumin, total protein, transferrin, IgG, IgA, IgM, C3 and C4 and blood lymphocyte counts were within normal limits. The mean serum insulin-like growth factor-I concentration, expressed as standard deviation score, as 0.74 +/- 1.5. No anthropometric or biochemical signs of malnutrition were found in children with moderate CRF. However, their dietary intake of calories and carbohydrates was low and the protein and saturated fatty acid intake excessively high.

Long-term enteral nutrition in infants and young children with chronic renal failure

“…They were included in the study if they had completed at least 12 months of EF. Their diagnoses were renal dysplasia [20], posterior urethral valves [9], occult neuropathic bladder with reflux nephropathy [1], congenital nephrotic syndrome [1], cortical necrosis [1], interstitial nephritis [2] and bilateral Wilms tumour [1]. In addition 6 children had major co-morbid conditions: 4 had congenital heart disease requiring major surgery in the first 4 months of life (coarctation of the aorta, ventricular septal defect, total anomalous pulmonary venous drainage and complex cyanotic heart disease), 1 had the CHARGE association [10] and 1 microcephaly associated with severe developmental delay.…”

“…However in practice it is often difficult to provide a "safe" nutritional intake and variable results have been reported with either oral energy supplements or enteral feeding (EF) [4][5][6][7]. Previous studies have clearly shown an inadequate spontaneous energy intake in children with CRF without intervention and a protein intake which exceeds the recommended dietary allowance (RDA) without specific dietary advice [8,9]. EF has been an integral part of the care of infants and children with CRF/ESRF at Great Ormond Street Hospital for Children since 1989, and this study retrospectively describes our long-term experience of EF, evaluating weight gain and linear growth, nutritional intake, biochemical parameters and outlook for normal feeding.…”

Compromised Diet Quality is Associated with Decreased Renal Function in Children with Chronic Kidney Disease

“…In the study of Norman et al [27], serum phosphorus levels in the children with GFR below 25 mL/min/1.73 m 2 were higher compared to those with GFR above 25 mL/min/1.73 m 2 , but serum calcium levels were not different between these two groups. Another study demonstrated that serum calcium and phosphorus levels were not different between the groups of GFR less and above 50 mL/min/1.73 m 2 [31]. In this study, serum calcium levels in the group of GFR below 75 mL/min/1.73 m 2 was lower compared to the group of GFR above 75 mL/min/1.73 m 2 .…”

Anthropometry of the trunk and extremities in nutritional assessment of children with chronic renal failure

“…Adequate nutrition and frequent adjustments of the nutritional prescriptions are important to achieving adequate nutritional intakes for normal pubertal growth in children with CRF. 23,24 Orejas et al 25 reported a normal anthropometric status in a group of children with moderate CRF. Our data, however, have shown significant differences in SH, LL, and CC between well-nourished children with mild to moderate CRF and healthy controls, even when they were in the same nutritional category.…”