| Theme | New Nutritional Assesment for Dialysis Patients | |
|---|---|---|
| Title | Nutritional management for children with end stage renal failure | |
| Publish Date | 2003/12 | |
| Author | Kenji Ishikura | Tokyo Metropolitan Kiyose Children's Hospital |
| Author | Hiroshi Hataya | Tokyo Metropolitan Kiyose Children's Hospital |
| Author | Masahiro Ikeda | Tokyo Metropolitan Kiyose Children's Hospital |
| Author | Masataka Honda | Tokyo Metropolitan Hachioji Children's Hospital |
| [ Summary ] | Adequate nutritional management is important to prevent both growth and developmental failure in children with end stage renal failure. Nutritional management influences even decision making for renal replacement therapies. Patients weighting under 30kg may require daily sessions of hemodialysis for metabolic control because of their higher protein and water demands for sufficient caloricintake. Peritoneal dialysis may be preferable for these patients. Malnutrition, even though subclinical, may cause lifelong morbidity. Meticulous observation of growth patterns and serial nutritional reassessment should be continued to achieve favorable outcomes. Glucose absorption from dialysate and protein loss into dialysate should be taken into account to evaluate total nutritional balance. Malnutrition can interfere with the interpretation of laboratory findings. For example, renal function of patients with low protein intake is overestimated when based on blood urea nitrogen. Protein equivalent of nitrogen appearance (PNA) is currently regarded as the optimal method to assess the nutritional status of adult patients. We have recently shown that PNA is reasonably applicable even for patients in the pediatric age group. |
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