Abstract
Objectives: To assess renal function in pediatric intestinal failure (IF) patients on long term home parenteral nutrition (HPN).Methods: Children who received HPN for a minimum of 3 years between 2007 and 2017 were identified from the IF clinic of a large tertiary referral center. Estimated glomerular filtration rate (eGFR) was calculated using the Schwartz formula at discharge on HPN, after 6 months, 1, 2, and 3 years.Results: Twenty five patients (40% male) fulfilled the inclusion criteria. The indications for HPN were due to an underlying motility disorder in 56% (14/25), enteropathy in 24% (6/25), and short bowel syndrome in 20% (5/25). At the start of HPN 80% (20/25) had a normal eGFR. Four children (17%) had an abnormal eGFR. In the group of patients with normal eGFR at the start of HPN 30% (6/20) had at least one episode of decreased eGFR in the following 3 years, however there was no significant decline in eGFR at the end of the 3 year study period. Overall there was no statistically significant deterioration of eGFR in the study population (p = 0.7898).Conclusion: In our cohort of children on long term HPN no significant decline of eGFR could be demonstrated within 3 years of starting PN.
Highlights
Children with prolonged or irreversible intestinal failure (IF) require long term parenteral nutrition (PN) [1]
Lifesaving long term PN is by far no panacea and associated with well-known complications such as central venous catheter (CVC) related blood stream infections, loss of central venous access, liver disease, pulmonary embolism, metabolic disturbances and bone disease [3,4,5]
Gender, weight and height and the duration of home PN, body mass index (BMI), and serum creatinine levels were obtained from the medical records
Summary
Children with prolonged or irreversible intestinal failure (IF) require long term parenteral nutrition (PN) [1]. Good quality of life can be achieved on home PN [2]. PN is usually infused overnight by a skilled carer. Depending on the underlying etiology of IF many children are able to eat and drink or tolerate at least enteral nutrition given via a feeding device. A group of young patients is fully PN dependent. Lifesaving long term PN is by far no panacea and associated with well-known complications such as central venous catheter (CVC) related blood stream infections, loss of central venous access, liver disease, pulmonary embolism, metabolic disturbances and bone disease [3,4,5]
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