Malnutrition Patterns in Children with Chronic Kidney Disease
Author:
Karava Vasiliki1, Dotis John1, Kondou Antonia1, Printza Nikoleta1ORCID
Affiliation:
1. Pediatric Nephrology Unit, 1st Department of Pediatrics, Hippokratio General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
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.
Subject
Paleontology,Space and Planetary Science,General Biochemistry, Genetics and Molecular Biology,Ecology, Evolution, Behavior and Systematics
Reference129 articles.
1. Nittari, G., Scuri, S., Sagaro, G.G., Petrelli, F., and Grappasonni, I. (2021). Teamwork in Healthcare, Intechopen. 2. Williams, J., Buoncristiano, M., Nardone, P., Rito, A.I., Spinelli, A., Hejgaard, T., Kierkegaard, L., Nurk, E., Kunešová, M., and Milanović, S.M. (2020). A Snapshot of European Children’s Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI). Nutrients, 12. 3. Sarcopenic Obesity in Children and Adolescents: A Systematic Review;Zembura;Front. Endocrinol.,2022 4. Protein energy wasting; what is it and what can we do to prevent it?;Rees;Pediatr. Nephrol.,2021 5. Underweight, overweight and obesity in paediatric dialysis and renal transplant patients;Bonthuis;Nephrol. Dial. Transplant.,2013
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