Assessment of Growth and Oxidized High-Density Lipoprotien Level in Children on Regular Hemodialysis

Abstract

Background: The cause of growth failure in chronic kidney disease (CKD) is multi-factorial with linear impairment being a final common pathway of various factors including malnutrition, increased catabolism, loss of nutrients and antioxidants, and aggressive dietary restrictions during dialysis .Anemia, metabolic acidosis and persistent micro inflammations are also causative factors. Objectives: To assess growth in children with CKD on regular hemodialysis and measure oxidized high density lipoprotein (OX-HDL), highly sensitive C-reactive protein (hsCRP) and to discuss their roles as a risk factors of malnutrition among studied cases. Patients and Methods: The study included 25 children with end stage renal disease (ESRD) on regular hemodialysis more than 6 months. Their ages ranged from 5-15 years with a mean of 10.76 years, also 25 of apparently healthy, age and sex matched were included. The study sample was selected from pediatric dialysis unit and outpatients clinic, of AL-Zahraa University hospital .Anthropometric measurements were assessed with determination of OX-HDL and hsCRP serum levels in both cases and the controls. Results: Anthropometry showed significant decrease in weight, height, body mass index, mid arm circumference and triceps skin fold thickness in patients when compared to the controls. 100% of patients had high level of OX-HDL and hsCRP, and positive correlation between OX-HDL and Z-score for Wt and Ht were detected. Conclusion: Malnutrition, and growth delay are common in children with chronic kidney disease on regular hemodialysis. High rate of inflammation in dialysis children as there were high level of hsCRP and OX‑HDL. HDL, in regular hemodialysis children loses its protective function as an anti-oxidant, anti-inflammatory and becomes pro-inflammatory factor.