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Erschienen in: Pediatric Nephrology 7/2014

01.07.2014 | Original Article

Protein energy wasting in children with chronic kidney disease

verfasst von: Alison G. Abraham, Robert H. Mak, Mark Mitsnefes, Colin White, Marva Moxey-Mims, Bradley Warady, Susan L. Furth

Erschienen in: Pediatric Nephrology | Ausgabe 7/2014

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Abstract

Background

In adults with chronic kidney disease (CKD), protein-energy wasting (PEW) is a risk factor for hospitalization and death. However, PEW in children with CKD is not well characterized or defined.

Methods

Using data from the Chronic Kidney Disease in Children study, we assessed three alternate definitions of PEW using biochemical parameters, body and muscle mass measurements, and reported appetite as described in adults: (1) a minimal PEW definition (≥2 of the four criteria); (2) a standard PEW definition (≥3 of the four criteria); (3) a modified PEW definition (≥3 of the four criteria plus a pediatric-focused criterion of short stature or poor growth).

Results

Of the 528 children analyzed in this study (median age 12 years, median glomerular filtration rate 45 mL/min/1.73 m2, 39 % female, 18 % African American), 7–20 % met the spectrum of definitions for PEW. The unadjusted incidence rates for incident hospitalizations were 1.9-, 2.1-, and 2.2-fold higher for those children diagnosed with PEW using the minimal, standard, and modified definitions, respectively (P = 0.08, 0.09 and 0.03). Following adjustment, only the modified PEW definition, which added short stature or poor growth as a criterion, showed modest significance (P = 0.06).

Conclusions

The inclusion of a criterion based on growth may augment the definition of PEW and improve risk discrimination in children with CKD.
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Metadaten
Titel
Protein energy wasting in children with chronic kidney disease
verfasst von
Alison G. Abraham
Robert H. Mak
Mark Mitsnefes
Colin White
Marva Moxey-Mims
Bradley Warady
Susan L. Furth
Publikationsdatum
01.07.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 7/2014
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-014-2768-9

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