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Review
. 2023 Mar 6;13(3):713.
doi: 10.3390/life13030713.

Malnutrition Patterns in Children with Chronic Kidney Disease

Vasiliki Karava  1 , John Dotis  1 , Antonia Kondou  1 , Nikoleta Printza  1
Affiliations
Review

Malnutrition Patterns in Children with Chronic Kidney Disease

Vasiliki Karava et al. Life (Basel). .

Abstract

Malnutrition is frequent in children with chronic kidney disease (CKD). Apart from undernutrition and protein energy wasting (PEW), overnutrition prevalence is rising, resulting in fat mass accumulation. Sedentary behavior and unbalanced diet are the most important causal factors. Both underweight and obesity are linked to adverse outcomes regarding renal function, cardiometabolic risk and mortality rate. Muscle wasting is the cornerstone finding of PEW, preceding fat loss and may lead to fatigue, musculoskeletal decline and frailty. In addition, clinical data emphasize the growing occurrence of muscle mass and strength deficits in patients with fat mass accumulation, attributed to CKD-related wasting processes, reduced physical activity and possibly to obesity-induced inflammatory diseases, leading to sarcopenic obesity. Moreover, children with CKD are susceptible to abdominal obesity, resulting from high body fat distribution into the visceral abdomen compartment. Both sarcopenic and abdominal obesity are associated with increased cardiometabolic risk. This review analyzes the pathogenetic mechanisms, current trends and outcomes of malnutrition patterns in pediatric CKD. Moreover, it underlines the importance of body composition assessment for the nutritional evaluation and summarizes the advantages and limitations of the currently available techniques. Furthermore, it highlights the benefits of growth hormone therapy and physical activity on malnutrition management.

Keywords: abdominal obesity; frailty; growth hormone; muscle strength; muscle wasting; obesity; physical activity; protein energy wasting; sarcopenia; sarcopenic obesity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Risk factors and outcomes of malnutrition in children with chronic kidney disease. (Abbreviations: CKD-MBD: chronic kidney disease-mineral and bone disorders, CV: cardiovascular, GFR: glomerular filtration rate, GH: growth hormone, IGF-1: insulin growth factor 1, PEW: protein energy wasting).
Figure 2
Figure 2
Malnutrition patterns based on body composition indices, including muscle mass, body fat percentage, body mass index and waist-to-height ratio, in children with chronic kidney disease. (Abbreviations: BF%: body fat percentage, BMI: body mass index, NWO: normal-weight obesity, WtHr: waist-to-height ratio).
See this image and copyright information in PMC

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