Assessment of nutritional status and volume distrubution of children with chronic kidney disease

BACKROUND: Malnutrition is well-described serious risk factor for morbidity and mortality in chronic kidney disease (CKD) of children. On the other hand, the determination of volume distribution abnormalities are difficult.The aim of this study was to investigate the nutritional status and volume distrubution of children with CKD in late stages.MATERIALS AND METHODS: Anthropometric measurements were done and serum albumin, prealbumin, transferrin, RBP-4, IGF-1, zinc, leptin, urea, creatinine, cholestrol, Na, K, Ca, P ve PTH, ALP, bicarbonate, hemoglobin, Fe, B12, folate, ferritin, CRP, fibrinojen TNF-alfa levels were investigated. Student?s t-test, Mann-Whitney U test and Krusgall Wallis test were used for statistically analysis.RESULTS: Total 52 children with CKD (stage III-IV (n=24), PD (n=16), HD (n=12)) and healthy children (n=46) were included to the study. SDS values of weight, height, body mass index, triceps scinfold thickness and mid arm circumference of CKD children were lower than the control group. BIA fat mass and body cell mass in CKD were found significantly decreased and fat free mass was found significantly increased than the control group. No difference was found in phase angles between two groups. Serum albumin, transferin, RBP-4, leptin, folate and zinc levels in CKD were significantly lower than the healthy children. Prealbumin, IGF-1, fe, B12 levels were not found different between two groups. The inflammation parameters as, serum TNF-alfa, ferritin and fibrinojen levels were higher in CKD than healthy children. BIA ICF was higher in CKD than the control. However, TBW and ECF were not different.CONCLUSION: We think that using of BIA with anthropometric measurements for nutritional assesment in CKD children might be helpful. In addition, visceral proteins, leptin and serum micronutrients should be measured for nutritional assesment of CKD. We also observed that inflammation had an important contribution in malnutrition in CKD of children.