TY - JOUR
T1 - Growth in very young children undergoing chronic peritoneal dialysis
AU - Rees, Lesley
AU - Azocar, Marta
AU - Borzych, Dagmara
AU - Watson, Alan R.
AU - Büscher, Anja
AU - Edefonti, Alberto
AU - Bilge, Ilmay
AU - Askenazi, David
AU - Leozappa, Giovanna
AU - Gonzales, Claudia
AU - van Hoeck, Koen
AU - Secker, Donna
AU - Zurowska, Aleksandra
AU - Rönnholm, Kai
AU - Bouts, Antonia H. M.
AU - Stewart, Heather
AU - Ariceta, Gema
AU - Ranchin, Bruno
AU - Warady, Bradley A.
AU - Schaefer, Franz
AU - AUTHOR GROUP
AU - Sojo, E.
AU - Coccia, P. A.
AU - Suarez, A.
AU - Valles, P. G.
AU - Salim, R.
AU - van Hoeck, K.
AU - Koch, V.
AU - Feber, J.
AU - Geary, D. A.
AU - White, C.
AU - Valenzuela, M.
AU - Villagra, J.
AU - Cano, F.
AU - Contreras, M. A.
AU - Vogel, A.
AU - Zambrano, P.
AU - Berrocal, P.
AU - Chiu, M. C.
AU - Xu, H.
AU - Vondrak, K.
AU - Rönnholm, K.
AU - Ranchin, B.
AU - Ulinski, T.
AU - Fischbach, M.
AU - Büscher, R.
AU - Kemper, M.
AU - Pape, L.
AU - Schaefer, F.
AU - Borzych, D.
AU - Groothoff, J. W.
PY - 2011
Y1 - 2011
N2 - Very young children with chronic kidney disease often have difficulty maintaining adequate nutrition, which contributes to the high prevalence of short stature in this population. Characteristics of the dialysis prescription and supplemental feeding via a nasogastric (NG) tube or gastrostomy may improve growth, but this is not well understood. Here, we analyzed data from 153 children in 18 countries who commenced chronic peritoneal dialysis at <24 months of age. From diagnosis to last observation, 57 patients were fed on demand, 54 by NG tube, and 10 by gastrostomy; 26 switched from NG to gastrostomy; and 6 returned from NG to demand feeding. North American and European centers accounted for nearly all feeding by gastrostomy. Standardized body mass index (BMI) uniformly decreased during periods of demand feeding and increased during NG and gastrostomy feeding. Changes in BMI demonstrated significant regional variation: 26% of North American children were obese and 50% of Turkish children were malnourished at last observation (P < 0.005). Body length decreased sharply during the first 6 to 12 months of life and then tended to stabilize. Time fed by gastrostomy significantly associated with higher lengths over time (P < 0.001), but adjustment for baseline length attenuated this effect. In addition, the use of biocompatible peritoneal dialysate and administration of growth hormone independently associated with improved length, even after adjusting for regional factors. In summary, growth and nutritional status vary regionally in very young children treated with chronic peritoneal dialysis. The use of gastrostomy feeding, biocompatible dialysis fluid, and growth hormone therapy associate with improved linear growth
AB - Very young children with chronic kidney disease often have difficulty maintaining adequate nutrition, which contributes to the high prevalence of short stature in this population. Characteristics of the dialysis prescription and supplemental feeding via a nasogastric (NG) tube or gastrostomy may improve growth, but this is not well understood. Here, we analyzed data from 153 children in 18 countries who commenced chronic peritoneal dialysis at <24 months of age. From diagnosis to last observation, 57 patients were fed on demand, 54 by NG tube, and 10 by gastrostomy; 26 switched from NG to gastrostomy; and 6 returned from NG to demand feeding. North American and European centers accounted for nearly all feeding by gastrostomy. Standardized body mass index (BMI) uniformly decreased during periods of demand feeding and increased during NG and gastrostomy feeding. Changes in BMI demonstrated significant regional variation: 26% of North American children were obese and 50% of Turkish children were malnourished at last observation (P < 0.005). Body length decreased sharply during the first 6 to 12 months of life and then tended to stabilize. Time fed by gastrostomy significantly associated with higher lengths over time (P < 0.001), but adjustment for baseline length attenuated this effect. In addition, the use of biocompatible peritoneal dialysate and administration of growth hormone independently associated with improved length, even after adjusting for regional factors. In summary, growth and nutritional status vary regionally in very young children treated with chronic peritoneal dialysis. The use of gastrostomy feeding, biocompatible dialysis fluid, and growth hormone therapy associate with improved linear growth
U2 - https://doi.org/10.1681/ASN.2010020192
DO - https://doi.org/10.1681/ASN.2010020192
M3 - Article
C2 - 22021715
SN - 1046-6673
VL - 22
SP - 2303
EP - 2312
JO - Journal of the American Society of Nephrology
JF - Journal of the American Society of Nephrology
IS - 12
ER -