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

19 Citations (Scopus)

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

Fingerprint

Renal Dialysis
Kidney
Urea
Dialysis
Young Adult
Dietary Proteins
Therapeutics
Nutritional Status
Growth Hormone
Body Weight
Proteins

Keywords

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

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Residual renal function and nutrition in young patients on chronic hemodialysis. / Guzzo, Isabella; Mancini, Elvira; Kengne Wafo, Séverin; Ravà, Lucilla; Picca, Stefano.

In: Pediatric Nephrology, Vol. 24, No. 7, 2009, p. 1391-1397.

Research output: Contribution to journalArticle

Guzzo, Isabella ; Mancini, Elvira ; Kengne Wafo, Séverin ; Ravà, Lucilla ; Picca, Stefano. / Residual renal function and nutrition in young patients on chronic hemodialysis. In: Pediatric Nephrology. 2009 ; Vol. 24, No. 7. pp. 1391-1397.
@article{9295e731060244b1b61f1d27506237ad,
title = "Residual renal function and nutrition in young patients on chronic hemodialysis",
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.",
keywords = "Chronic hemodialysis, Nutrition, Protein catabolic rate, Recombinant human growth hormone, Residual renal function",
author = "Isabella Guzzo and Elvira Mancini and {Kengne Wafo}, S{\'e}verin and Lucilla Rav{\`a} and Stefano Picca",
year = "2009",
doi = "10.1007/s00467-009-1144-7",
language = "English",
volume = "24",
pages = "1391--1397",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "7",

}

TY - JOUR

T1 - Residual renal function and nutrition in young patients on chronic hemodialysis

AU - Guzzo, Isabella

AU - Mancini, Elvira

AU - Kengne Wafo, Séverin

AU - Ravà, Lucilla

AU - Picca, Stefano

PY - 2009

Y1 - 2009

N2 - 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.

AB - 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.

KW - Chronic hemodialysis

KW - Nutrition

KW - Protein catabolic rate

KW - Recombinant human growth hormone

KW - Residual renal function

UR - http://www.scopus.com/inward/record.url?scp=67349271546&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67349271546&partnerID=8YFLogxK

U2 - 10.1007/s00467-009-1144-7

DO - 10.1007/s00467-009-1144-7

M3 - Article

C2 - 19271246

AN - SCOPUS:67349271546

VL - 24

SP - 1391

EP - 1397

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 7

ER -