Anthropometric and growth assessment of children receiving renal replacement therapy in Malaysia

Abstract

Objective: To report on the anthropometric and growth status of children receiving renal replacement therapy (RRT) in Malaysia. Design: Cross-sectional study with some retrospective elements. Setting: Outpatients' clinics in a major referral hospital in Malaysia. Patients: Fifteen renal transplants (mean age, 13.3 ± 2.8 years) and 35 continuous ambulatory peritoneal dialysis (CAPD) patients (mean age, 12.6 ± 3.0 years) participated. The RRT period ranged between 3 months to 6 years for both groups. Intervention: None. Main Outcome Measures: Body mass index (BMI), percent body fat (% BF), triceps skinfold (TSF), mid upper-arm circumference (MUAC), arm muscle area (AMA), and z scores for height and weight. Results: BMI for age indicated 7% of transplant subjects (TS) versus 40% of CAPD subjects were below the 5th percentile, whereas only 7% of TS were above the 95th percentile. % BF was higher for TS compared with the CAPD group for both sexes (boys, 19.5% and girls, 29.8% v boys, 12.4% and girls, 21.5%). Despite higher percentiles for TSF, transplant subjects still showed depleted muscle mass based on MUAC and AMA. z scores for height showed 93% of transplant subjects and 62% of CAPD subjects below −2 standard deviation (SD), whereas for weight these were 27% and 54%, respectively. Sixty-four percent of TS experienced catch-up growth for height and 86% for weight. These percentages were approximately halved for the CAPD group (32% and 43%, respectively). Conclusion: Patterns of growth and body composition appear distinctly different with the different RRT modalities. Serial anthropometric evaluation appears vital in pre- and post-RRT monitoring in pediatric renal populations. © 2002 by the National Kidney Foundation, Inc.