The impact of nutritional management on the growth and nutritional status of children on regular hemodialysis.

IF 2.6 3区医学 Q1 PEDIATRICS

Pediatric Nephrology Pub Date : 2025-10-10 DOI:10.1007/s00467-025-06940-w

Heba Mostafa Ahmed, Esraa Abdelal Shafey, Rehab Muhammad Abd El Kareem, Wesam Ali Ibrahim, Osama Ezzat Botrous

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Abstract

Background: Chronic kidney disease (CKD) is a relatively uncommon disease in children. A child's nutritional status indicates how well their body is getting the required nutrients. This research aimed to determine the nutritional state of hemodialysis-treated children with end-stage kidney failure.

Patients and methods: A case group of 50 children with kidney failure undergoing hemodialysis was compared with a control group of 50 healthy children of the same age. A structured interview questionnaire was used with the children or their mothers, covering nutritional assessment, physical examination, anthropometric measurements, and lab tests. Dietary intake was evaluated through 24-hour recalls, and each case's dietary consumption was analyzed, followed by nutritional education. Children were reassessed after a 6-month follow-up.

Results: Most children with kidney failure initially had height and weight below the 5th percentile, with Mid Upper Arm Circumference (MUAC) below -3 SD. Dietary recall initially revealed low caloric intake (p = 0.046), high sodium (p = 0.06), high potassium (p = 0.01), high phosphorus (p < 0.01), and low calcium (p < 0.009) compared to controls. By study's end, MUAC and weight percentiles improved (p = 0.045 and 0.039). Lab results showed significant decreases in urea (p = 0.005), creatinine (p < 0.001), sodium (p < 0.001), potassium (p = 0.001), uric acid (p < 0.001), phosphorus (p = 0.04), and parathormone (p = 0.03) from baseline.

Conclusion: Our study suggests that appropriately targeted nutrition education in children with CKD can improve weight centiles and MUAC and deranged renal biochemistry (including low serum albumin and raised serum potassium).

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营养管理对定期血液透析患儿生长发育及营养状况的影响。

背景：慢性肾脏疾病（CKD）是儿童中一种相对少见的疾病。儿童的营养状况表明他们的身体获得所需营养的程度。本研究旨在确定血液透析治疗的终末期肾衰竭儿童的营养状况。患者与方法：将50例接受血液透析治疗的肾衰竭患儿与50例同龄健康患儿进行对照。对儿童或其母亲采用结构化访谈问卷，内容包括营养评估、体格检查、人体测量和实验室测试。通过24小时回顾评估饮食摄入量，分析每个病例的饮食消耗，然后进行营养教育。随访6个月后对儿童进行重新评估。结果：大多数肾衰竭患儿最初的身高和体重低于第5百分位，中上臂围（MUAC）低于-3 SD。饮食回忆最初显示，与对照组相比，低热量摄入（p = 0.046）、高钠（p = 0.06）、高钾（p = 0.01）、高磷（p < 0.01）和低钙（p < 0.009）。研究结束时，MUAC和体重百分位数均有所改善（p = 0.045和0.039）。实验室结果显示，与基线相比，尿素（p = 0.005）、肌酐（p < 0.001）、钠（p < 0.001）、钾（p = 0.001）、尿酸（p < 0.001）、磷（p = 0.04）和甲状旁激素（p = 0.03）显著降低。结论：本研究提示，对CKD患儿进行适当的有针对性的营养教育，可改善体重、MUAC和肾生化紊乱（包括低血清白蛋白和高血清钾）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Nephrology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

20.00%

发文量

465

审稿时长

1 months

期刊介绍： International Pediatric Nephrology Association Pediatric Nephrology publishes original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies may involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. There are 12 issues per year that contain Editorial Commentaries, Reviews, Educational Reviews, Original Articles, Brief Reports, Rapid Communications, Clinical Quizzes, and Letters to the Editors.