nPCR assessment and IDPN treatment of malnutrition in pediatric hemodialysis patients.

Abstract

Very few pediatric studies have monitored nutritional status using normalized protein catabolic rate (nPCR) or treating protein-energy malnutrition (PEM) with intradialytic parenteral nutrition (IDPN). The current study compares nPCR with serum albumin as a marker for nutritional status and examines the effectiveness of IDPN treatment in three malnourished adolescent patients receiving chronic hemodialysis in a pediatric dialysis unit. All patients demonstrated reversal of weight loss and initiation of weight gain within 6 weeks of IDPN initiation. Mean values of monthly percentage weight and percentage body mass index (BMI) change were significantly lower in the pre-IDPN era (-0.61+/-2.70 and -1.3+/-2.7) versus the IDPN treatment period (1.8+/-2.1 and 1.3+/-2.1) ( P<0.02). Two patients attained ideal body weight and IDPN was discontinued after 5 months. Patients required 150% recommended daily allowance to achieve weight and BMI gain. While mean monthly nPCR was significantly lower in the pre-IDPN period versus the IDPN period (1.05+/-0.36 versus 1.35+/-0.37, P<0.05), monthly serum albumin levels were no different before and after IDPN was initiated (3.7+/-0.8 versus 3.8+/-0.6). The current study demonstrates IDPN to be effective therapy for adolescent hemodialysis patients with PEM not correctable by enteral supplementation. nPCR was superior to serum albumin as a nutritional status marker in these malnourished pediatric patients receiving hemodialysis.

• Authors: Stuart L Goldstein, Shannon Baronette, Tywanna Vital Gambrell, Helen Currier, Eileen D Brewer
• Journal: Pediatric nephrology (Berlin, Germany) (Pediatr Nephrol) Vol. 17 Issue 7 Pg. 531-4 (Jul 2002) ISSN: 0931-041X [Print] Germany
• PMID: 12172769 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Proteins
• Serum Albumin

Topics

• Adolescent
• Adolescent Nutritional Physiological Phenomena
• Adult
• Body Weight
• Humans
• Kidney Failure, Chronic (complications, therapy)
• Parenteral Nutrition (methods)
• Protein-Energy Malnutrition (diagnosis, etiology, therapy)
• Proteins (metabolism)
• Renal Dialysis (methods)
• Sensitivity and Specificity
• Serum Albumin (metabolism)