Residual renal function and nutrition in young patients on chronic hemodialysis

Isabella Guzzo, Elvira Mancini, Séverin Kengne Wafo, Lucilla Ravà, Stefano Picca

Research output: Contribution to journalArticle

Abstract

Residual renal function (RRF) has been associated with a better nutritional status in adult patients on chronic dialysis, but there is as yet no data available for young patients on chronic hemodialysis (HD). We have retrospectively analyzed 3-day dietary reports and simultaneous urea kinetic monitoring data (n = 179) of 30 children, adolescents and young adults on chronic HD. The protein catabolic rate (PCR) was calculated and normalized by body weight (nPCR). The HD dialysis dose (Kt/VHD), RRF (calculated by urea clearance, Ku, and expressed as residual Kt/V) and total Kt/V (Kt/Vtot) were evaluated. In all patients, nPCR was correlated with dietary protein intake (nDPI) (p <0.0001) and Kt/Vtot (p <0.0001) but not with Kt/VHD (p = 0.11). In patients with RRF, Ku was associated with nPCR (p <0.0001), while Kt/VHD was not (p = 0.10), and nPCR was higher than in patients without RRF (1.46 ± 0.41 vs. 1.03 ± 0.33 g/kg/day; p <0.0001). Patients on recombinant growth hormone (rhGH) treatment showed higher nPCR values than those without rhGH (1.34 ± 0.41 vs. 1.01 ± 0.39 g/kg/day; p <0.0001). In a multiple regression model including age, rhGH treatment, RRF, Kt/Vtot and Kt/VHD, and nPCR showed the best correlation with RRF (β = 0.128; p <0.0001). In conclusion, in children, adolescents and young adults on chronic HD treatment, RRF positively affects nutrition independently of HD efficiency and rhGH treatment.

Original languageEnglish
Pages (from-to)1391-1397
Number of pages7
JournalPediatric Nephrology
Volume24
Issue number7
DOIs
Publication statusPublished - 2009

Keywords

  • Chronic hemodialysis
  • Nutrition
  • Protein catabolic rate
  • Recombinant human growth hormone
  • Residual renal function

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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