الفهرس | Only 14 pages are availabe for public view |
Abstract •Background: Nutritional status of children with chronic kidney disease (CKD) is important since it affects growth and development and may even affect disease process. Aggressive nutrition intervention in the early stages of CKD may be critical in the prevention of more serious complications further in the disease process. Provision of adequate nutrition is especially important in infants and young children because growth depends strongly on nutrition during early childhood. The aim of the work: Assess nutritional status in children with chronic kidney disease whether predialysis (only stage 3 & 4) or on hemodialysis(stage 5D), evaluate the deviation of received nutrients from the recommended allowance for age, sex and disease stage & study the relation of dietary intake to body composition, growth and biochemical parameters. Type of study: An observational cross sectional descriptive study. Materials and Methods: An observational cross sectional descriptive study that was carried out in Nephrology unit Mansoura University Children’s Hospital. The study was included a group of CKD children with predialysis or on hemodialysis. An informed consent was be obtained from the parents of all patients before enrollment. Results: In our study, Anthropometric measurements (weight Z, height Z and BMI Z) have a statistically significant decrease in dialytic patients than non-dialytic patients. All CBC parameters have a statistically significant decrease in patients on dialysis than non-dialytic patients. Serum electrolytes: (Calcium) has a statistically significant decrease in patients on dialysis than not while (Na, K and Ph) do not have any significant difference between two groups. GFR & serum albumin have a statistically significant decrease in patients on dialysis than non-dialytic patients but serum creatinine has a statistically significant increase in dialytic patients than non dialytic patients. ABG parameters (pH and HCO3) have a statistically significant increase in patients on dialysis than not while PCO2 does not have any significant difference between two groups. Among patients on dialysis 35% were malnutrition while 65% were normal according to nPCR. BUN among patients on dialysis has a statistically increase in pre than post. Food analysis were compared between CKD patients and RDA of CKD Patients; protein , Zn and Na are statistically significant increase in CKD than RDA while CHO, fat, energy, Ca, Ph and K are statistically significant decrease in CKD than RDA. Body composition between patients on dialysis compared to not; water base line and its levels have statistically significance difference between patients on dialysis than not while in patients on dialysis (pre and post dialysis); water base line is statistically lower in post dialysis compared to predialysis. There was no statistically significance difference between patient on dialysis than not according to LTI and FTI. •Conclusion: Growth affection is significant in all CKD patients & more in dialytic patients than non dialytic patients. Serum albumin is lower in dialytic patients with lower protein intake than non dialytic patients. nPCR is not affected in many dialytic patients due to good protein intake of our dialytic patients which is higher than RDA of CKD patients. Many dietary elements (carbohydrates, fat, calcium, phosphorus, potassium) in all CKD patients are lower than RDA, while (protein, fat, iron, calcium, potassium, phosphorous) are lower in dialytic patients than non dialytic patients. Energy requirement of all CKD patients is lower than RDA of CKD patients. •Recommendations: Increase energy requirement of all CKD patients, increase the following items (CHO, Fat, Calcium and Potassium) in diet of CKD patients, decrease the following items (sodium, zinc, protein) content in the diet of our CKD patients. Further researches are needed to support the results of this study. |