Bioelectrical Impedance Analysis for Nutritional Assessment in Children with Chronic Kidney Disease

Background: Malnutrition and growth failure are major problems among children with chronic kidney disease (CKD). No single metric can describe their nutritional status; therefore, a series of indices and methods are required for evaluation. Aim of the Work: Evaluation of the nutritional status of children with CKD using dietetic history, anthropometric measurements, biochemical parameters and BIA. Methods:  This case-control study was conducted on forty CKD children (stages 3-5) from those attending Pediatric Department, Tanta University Hospitals between March 2021 and February 2022 in comparison to forty healthy control children. All were subjected to: dietetic history, anthropometric measurements including (weight, height, body mass index, mid-arm circumference, skin fold thickness), BIA using TANITA Body Composition Analyzer MC-980 MA-N plus III device and laboratory investigations: (CBC, urea, creatinine, ABG, sodium, potassium, phosphorus, calcium, alkaline phosphatase, parathormone hormone, serum proteins, albumin and 24hrs urinary proteins). Results: CKD children had significantly lower caloric intake and other nutrient consumption including protein, carbohydrate and fat intake (p < 0.05), significantly lower anthropometric measurements including weight, height, body mass index, skinfold thickness and mid-arm circumference than controls (p < 0.05) and significantly lower in BIA measurements including fat mass (FM), fat free mass (FFM), muscle mass (MM), total body water (TBW) and bone mass (BM) than controls. There was significant positive correlation between caloric intake and protein intake with FFM, MM, SMM, BM, TBW and BMR, also there was significant positive correlation between serum albumin and FFM, MM, SMM, BM and TBW in CKD patients. Conclusions: CKD children had low caloric and protein intake, low body composition parameters, so good nutritional assessment and improvement of their nutritional status is very important. BIA could be used with dietary assessment and anthropometric measurements to achieve more accurate nutritional evaluation in CKD children.