The effect of regular hemodialysis on the nutritional status of children with end-stage renal disease

Abstract

Growth failure is one of the most common and profound clinical manifestation of chronic kidney disease (CKD) in infants, children and adolescents. The aim of this study was to assess the nutritional status of Egyptian children with end-stage renal disease (ESRD) on regular hemodialysis (HD). The study included 50 Egyptian children with ESRD on regular HD, following-up at the Pediatric Nephrology unit, Cairo University. History, including dietary history, was taken for all patients and clinical examination was performed on all of them. Body weight, standing height, height or length SD score, the skin fold thickness, mid-arm circumference, mid-arm muscle circumference and mid-arm muscle circumference area were also assessed. The height of the patients was the most affected anthropometric parameter, as 78% of the patients were shorter (height SDS below -3). Body weight is less affected than height, as body weight SDS of 34% of patients was less than -3 SDS. In addition, the body mass index of 16% of the patients was <3 rd percentile, while only 4% of the patients were >97 th percentile. Although most ESRD patients received adequate protein and caloric intake, their growth was markedly affected, especially with longer period on HD. We suggest that assessment of growth parameters should be performed at a minimum period of every six months in children with CKD stages 2-3. For children with more advanced CKD (stages 4-5 and 5D), more frequent evaluation may be warranted due to the greater risk of abnormalities.