Nutrition assessment and management in children on peritoneal dialysis

Fabio Paglialonga, Alberto Edefonti

Research output: Contribution to journalArticlepeer-review

Abstract

Protein-calorie malnutrition, otherwise known as cachexia, is a common problem in children undergoing chronic peritoneal dialysis (PD) and is a frequent source of significant morbidity and mortality. Recent evidence suggests that the main factors involved in the pathogenesis are metabolic acidosis, a decreased response to anabolic hormones, and chronic inflammation, associated with hormonal imbalances and an increased metabolic rate. Given the complexity and multifactorial nature of cachexia, the assessment of nutritional status in children on PD requires a complete history and physical examination; assessment of dietary intake, biochemical indices, and anthropometry; and possibly bioimpedance analysis and combined score systems. Its management should likewise be multidisciplinary and include ensuring an adequate energy and protein intake; optimal metabolic control, with the correction of acidosis, anaemia, and hyperparathyroidism; an optimal (or at least adequate) dialysis dose; and, if necessary, prescription of specific drugs such as recombinant human growth hormone.

Original languageEnglish
Pages (from-to)721-730
Number of pages10
JournalPediatric Nephrology
Volume24
Issue number4
DOIs
Publication statusPublished - 2009

Keywords

  • Anthropometry
  • Bioimpedance analysis
  • Cachexia
  • Malnutrition
  • Nutrition
  • Nutritional status
  • Peritoneal dialysis

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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