Efficacy of intradialytic amino acids on nutritional status in children with stage 5 chronic kidney disease

Background Protein energy wasting (PEW) is a common cause of morbidity and mortality in patients with stage 5 chronic kidney disease (CKD 5). Intradialytic parenteral nutrition (IDPN) has been used as a therapy for preventing and treating PEW in children with CKD 5 when other conventional modalities...

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Bibliographic Details
Published in:	Pediatric nephrology (Berlin, West) Vol. 36; no. 6; pp. 1561 - 1569
Main Authors:	El-Serw, Hagar El-Saied Saad, Bassiouni, Dina Abdel Rasoul Helal, Al-Wakeil, Angy Adel, El-Masry, Ragaa Shawky Aly Ibrahim, Bakr, Ashraf Mohamed Abd EI Basset
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2021 Springer Springer Nature B.V
Subjects:	Adipose tissue Albumin Amino Acids Body composition Care and treatment Child Child Nutrition Disorders Children Cholesterol Chronic kidney failure Complications and side effects Dialysis Hand Strength Health aspects Humans Intravenous administration Kidney diseases Kidney Failure, Chronic Malnutrition Malnutrition - etiology Malnutrition - prevention & control Malnutrition in children Medicine Medicine & Public Health Methods Morbidity Nephrology Nutritional Status Original Article Parenteral feeding Parenteral nutrition Parenteral therapy Pediatric research Pediatrics Placebos Prospective Studies Protein-Energy Malnutrition Renal Dialysis - adverse effects Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - therapy Urology What’s New in Chronic Kidney Disease Egypt Parenteral nutrition Amino acids Dialysis Kidney failure Children Protein energy wasting
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Summary:	Background Protein energy wasting (PEW) is a common cause of morbidity and mortality in patients with stage 5 chronic kidney disease (CKD 5). Intradialytic parenteral nutrition (IDPN) has been used as a therapy for preventing and treating PEW in children with CKD 5 when other conventional modalities fail. However, not enough data is available to define its effectiveness in treating malnutrition in children. This study aims to investigate potential benefits of IDPN in Egyptian children with CKD 5. Methods In this prospective, placebo-controlled, parallel-group single blinded study, we enrolled 50 CKD 5 patients; 25 patients (intervention group) received intravenous amino acids (KIDIMN), while 25 patients (control group) received normal saline as placebo, each given during regular dialysis 3 times a week for 9 months. Patients were subjected to nutritional assessment at baseline and 3-, 6-, and 9-month follow-up using height Z-score, hand grip strength (HGS) for muscle power assessment, body composition monitor (BCM) for assessing lean tissue mass (LTM) and adipose tissue mass (ATM), and biochemical measures including serum albumin, serum triglyceride, and serum cholesterol. Results When comparing baseline and 9-month follow-up values, significant improvement was recorded in height Z-score, LTM, and serum albumin in the intervention group unlike the control group where no significant changes were recorded. Conclusion IDPN is proposed to be an effective method for preventing and treating malnutrition in children with CKD 5. However, further multi-centric studies with larger sample size and longer duration of follow-up are still recommended.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0931-041X 1432-198X
DOI:	10.1007/s00467-020-04806-x