Abstract
Twenty-two infants (mean age 7.5 months) with chronic renal failure (CRF) were studied for their nutrition, growth, and upper gastrointestinal function. Most infants had a history of poor caloric intake and 7 had received supplemental feeding (SF) prior to the investigation. All infants were undergrown, underweight, and malnourished. The infants were characterized as having only a fair interest in food, refusing feedings, and vomiting excessively. Sixteen of 22 infants (73%) had significant gastroesophageal (GE) reflux demonstrated by 24-h esophageal pH monitoring. Gastroesophageal scintiscans were less sensitive and specific in detecting the reflux. Infants with GE reflux were significantly younger and more often required SF than those without GE reflux. There were no significant differences in the degree of renal failure, growth failure, caloric intake, protein intake, or nutritional status between the infants with and without GE reflux. From these studies we conclude that GE reflux should be considered as one of the factors contributing to the feeding problems of infants with CRF.
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References
Betts PR, Magrath G (1974) Growth pattern and dietary intake of children with chronic renal insufficiency. Br Med J 2: 189–193
Jones RWA, Rigden SP, Barratt TM, Chantler C (1982) The effect of chronic renal failure in infancy on growth, nutritional status and body composition. Pediatr Res 16: 784–791
Wassner SJ, Abitbol C, Alexander S, Conley S, Grupe WE, Holliday MA, Rigden S, Salusky IB (1986) Nutritional requirements for infants with renal failure. Am J Kidney Dis 7: 300–305
Schwartz GJ, Feld LG, Langford DJ (1984) A simple estimate of glomerular filtration rate in full-term infants during the first year of life. J Pediatr 104: 849–854
Barrett TM, Broyer M, Chantler C, Gilli G, Guest G, Marti-Henneberg C, Preece MA, Rigden SPA (1986) Assessment of growth. Am J Kidney Dis 7: 340–346
Euler AR, Byrne WJ (1981) Twenty-four hour esophageal intraluminal pH probe testing: a comparative analysis. Gastroenterology 80: 957–961
Strobel CT, Byrne WJ, Ament ME, Euler AR (1979) Correlation of esophageal length in children with height: application to the Tuttle test without prior esophageal manometry. J Pediatr 94: 81–84
Karlberg P, Engstrom I, Lichtenstein H, Svennberg I (1968) The development of children in a Swedish urban community. A prospective longitudinal study. III. Physical growth during the first three years of life. Acta Pediatr Scand [Suppl] 187: 48–66
Frisancho AR (1981) New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr 34: 2540–2545
Waterlow JC (1972) Classification and definition of protein-calorie malnutrition. Br Med J 3: 566–569
Boix-Ochoa J, Lafuente JM, Gil-Vernet JM (1980) Twenty-four hour esophageal pH monitoring in gastroesophageal reflux. J Pediatr Surg 15: 74–78
Koch A, Gass R (1981) Continuous 20–24 hour esophageal pH monitoring in infancy. J Pediatr Surg 16: 109–113
Vandenplas Y, Sacre-Smits L (1985) Seventeen-hour continuous esophageal pH monitoring in the newborn: evaluation of the influence of position in asymptomatic and symptomatic babies. J Pediatr Gastroenterol Nutr 4: 356–361
Herbst JJ, Minton SD, Book LS (1979) Gastroesophageal reflux causing respiratory distress and apnea in newborn infants. J Pediatr 95: 763–768
Herbst JJ (1985) Gastroesophageal reflux in infants. J Pediatr Gastroenterol Nutr 4: 163–164
Herbst JJ (1981) Gastroesophageal reflux. J Pediatr 98: 859–870
Boix-Ochoa J, Canals J (1976) Maturation of the lower esophagus. J Pediatr Surg 11: 749–756
Meyers WF, Roberts CC, Johnson DG, Herbst JJ (1985) Value of tests for evaluation of gastroesophageal reflux in children. J Pediatr Surg 20: 515–525
Jolley SG, Herbst JJ, Johnson DG, Matlak ME, Book LS (1981) Esophageal pH monitoring during sleep identifies children with respiratory symptoms from gastroesophageal reflux. Gastroenterology 80: 1501–1506
McGraw ME, Haka-Ikse K (1985) Neurologic-developmental sequela of chronic renal failure in infants. J Pediatr 106: 579–583
Foley CM, Polinsky MS, Gruskin AB, Baluarte HJ, Grover WD (1981) Encephalopathy in infants and children with chronic renal disease. Arch Neurol 38: 656–658
Bock GH, Conry JA, Ruley EJ, Samango-Sprouse CA, Connors CK, Weiss I, Eng G, Johnson EL (1989) Disturbances of brain maturation and neurodevelopment during chronic renal failure in infancy. J Pediatr 114: 231–238
Wright RA, Clemente R, Wathen R (1984) Gastric emptying in patients with chronic renal failure receiving hemodialysis. Ann Intern Med 144: 495–496
McNamee PT, Moore GW, McGeown MG, Doherty CC, Collins BJ (1985) Gastric emptying in chronic renal failure. Br Med J 291: 310–311
Ramenofsky ML, Leape LL (1981) Continuous upper esophageal pH monitoring in infants and children with gastroesophageal reflux, pneumonia, and apneic spells. J Pediatr Surg 16: 374–378
Arasu TS, Wyllie R, Fitzgerald JF, Franken EA, Siddiqui AR, Lehman GA, Eigen H, Grosfeld JL (1980) Gastroesophageal reflux in infants and children — comparative accuracy of diagnostic methods. J Pediatr 96: 798–803
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Ruley, E.J., Bock, G.H., Kerzner, B. et al. Feeding disorders and gastroesophageal reflux in infants with chronic renal failure. Pediatr Nephrol 3, 424–429 (1989). https://doi.org/10.1007/BF00850220
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DOI: https://doi.org/10.1007/BF00850220