TY - JOUR
T1 - Global Variation of Nutritional Status in Children Undergoing Chronic Peritoneal Dialysis
T2 - A Longitudinal Study of the International Pediatric Peritoneal Dialysis Network
AU - International Pediatric Peritoneal Dialysis Network (IPPN) Registry
AU - Schaefer, Franz
AU - Benner, Laura
AU - Borzych-Dużałka, Dagmara
AU - Zaritsky, Joshua
AU - Xu, Hong
AU - Rees, Lesley
AU - Antonio, Zenaida L.
AU - Serdaroglu, Erkin
AU - Hooman, Nakysa
AU - Patel, Hiren
AU - Sever, Lale
AU - Vondrak, Karel
AU - Flynn, Joseph
AU - Rébori, Anabella
AU - Wong, William
AU - Hölttä, Tuula
AU - Yildirim, Zeynep Yuruk
AU - Ranchin, Bruno
AU - Grenda, Ryszard
AU - Testa, Sara
AU - Drożdz, Dorota
AU - Szabo, Attila J.
AU - Eid, Loai
AU - Basu, Biswanath
AU - Vitkevic, Renata
AU - Wong, Cynthia
AU - Pottoore, Stephen J.
AU - Müller, Dominik
AU - Dusunsel, Ruhan
AU - Celedon, Claudia Gonzalez
AU - Fila, Marc
AU - Sartz, Lisa
AU - Sander, Anja
AU - Warady, Bradley A.
AU - Adragna, M.
AU - Coccia, P. A.
AU - Suarez, A.
AU - Valles, P. G.
AU - Salim, R.
AU - Alconcher, L.
AU - Arbeiter, K.
AU - van Hoeck, K.
AU - Koch, V.
AU - Feber, J.
AU - Harvey, E.
AU - White, C.
AU - Valenzuela, M.
AU - Villagra, J.
AU - Cano, F.
AU - Landau, D.
N1 - Publisher Copyright:
© 2019, The Author(s).
PY - 2019/12/1
Y1 - 2019/12/1
N2 - While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was most prevalent in South and Southeast Asia (20%), Central Europe (16.7%) and Turkey (15.2%), whereas overweight and obesity were most common in the Middle East (40%) and the US (33%). BMI SDS at PD initiation was associated positively with current eGFR and gastrostomy feeding prior to PD start. Over the course of PD BMI SDS tended to increase on CPD in underweight and normal weight children, whereas it decreased in initially overweight patients. In infancy, mortality risk was amplified by obesity, whereas in older children mortality was markedly increased in association with underweight. Both underweight and overweight are prevalent in pediatric ESKD, with the prevalence varying across the globe. Late dialysis start is associated with underweight, while enteral feeding can lead to obesity. Nutritional abnormalities tend to attenuate with time on dialysis. Mortality risk appears increased with obesity in infants and with underweight in older children.
AB - While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was most prevalent in South and Southeast Asia (20%), Central Europe (16.7%) and Turkey (15.2%), whereas overweight and obesity were most common in the Middle East (40%) and the US (33%). BMI SDS at PD initiation was associated positively with current eGFR and gastrostomy feeding prior to PD start. Over the course of PD BMI SDS tended to increase on CPD in underweight and normal weight children, whereas it decreased in initially overweight patients. In infancy, mortality risk was amplified by obesity, whereas in older children mortality was markedly increased in association with underweight. Both underweight and overweight are prevalent in pediatric ESKD, with the prevalence varying across the globe. Late dialysis start is associated with underweight, while enteral feeding can lead to obesity. Nutritional abnormalities tend to attenuate with time on dialysis. Mortality risk appears increased with obesity in infants and with underweight in older children.
UR - https://www.scopus.com/pages/publications/85063350902
U2 - 10.1038/s41598-018-36975-z
DO - 10.1038/s41598-018-36975-z
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C2 - 30894599
AN - SCOPUS:85063350902
SN - 2045-2322
VL - 9
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 4886
ER -
SDG 3 Good Health and Well-being