Anthropometric and biochemical profile of children and adolescents with chronic kidney disease in a predialysis pediatric interdisciplinary program.

Vanessa R Silva,Ana Cristina Simões E Silva,Juliana O Magalhães,Cristina B Soares,Isabella Peixoto De Barcelos,Eduardo A Oliveira,Debora C Cerqueira

doi:10.1155/2015/810758

Vanessa R Silva, Ana Cristina Simões E Silva + Show 5 more

Open Access

https://doi.org/10.1155/2015/810758

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Abstract

This is longitudinal retrospective observational cohort study that evaluated anthropometric and biochemical variables of children and adolescents admitted to a Predialysis Interdisciplinary Management Program (PDIMP) responsible for the follow-up of children and adolescents at stages 2 to 4 of chronic kidney disease (CKD) at a tertiary center. One hundred thirty-eight patients with CKD on predialysis treatment with median age at admission of 9 years and the median follow-up time of 5 years were evaluated. Seventy-four (53%) had CKD stage 3 at admission and 70 (51%) reached CKD stage 5 at the end of the follow-up. There was no significant difference between the mean initial and final hemoglobin and serum albumin. However, the final serum bicarbonate presented a significant improvement. Analyses stratified according to clinical variables of interest showed a significant improvement in body mass index (BMI) Z score, especially in the subgroup of children admitted under two years of age. In relation to stature-for-age Z score, data show a significant improvement in stature SD at the end of the study. In conclusion, the present study showed improvement of nutritional status of CKD patients and that the deterioration of renal function was not correlated with BMI-for-age Z score.

Highlights

International data on the incidence of pediatric patients at predialysis chronic kidney disease (CKD) range from 5.7 to 12 cases per million of age related population and the prevalence of 42.5 to 75 cases per million of age related population [1]
The mean glomerular filtration rate (GFR) was of 38.2 ± 15.6 mL/min/1.73 m2, whereas at last follow-up visit the mean GFR decreased to 28.3 ± 21.8 mL/min/1.73 m2
In spite of the expected decline of renal function for the majority of patients, deterioration of renal function was not significantly correlated with nutritional status at last followup visit (r = −0.078, P = 0.40) (Figure 4). In this retrospective cohort study of children and adolescents with CKD admitted to a predialysis pediatric interdisciplinary program we reported anthropometric and biochemical data at baseline and at last follow-up visit

Summary

Introduction

International data on the incidence of pediatric patients at predialysis chronic kidney disease (CKD) range from 5.7 to 12 cases per million of age related population and the prevalence of 42.5 to 75 cases per million of age related population [1]. The following five major components of the dietary prescription must be considered: energy, macronutrients, fluids and electrolytes, micronutrients, and calcium/phosphorus/vitamin D [7]. Nutritional care of these patients should be focused on maintaining adequate nutritional status, body mass index (BMI) Z score between −2 and +1, and height for age greater than or equal to −2 Z score [4, 8].

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