NUTRITIONAL STATUS AND GROWTH PATTERNS IN CHILDREN WITH CHRONIC KIDNEY DISEASE: A HOSPITAL-BASED CROSS-SECTIONAL ANALYSIS
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Keywords
chronic kidney disease, pediatric nutrition, growth failure, malnutrition, stunting
Abstract
Introduction: Chronic kidney disease (CKD) in children is associated with significant growth failure and malnutrition, with limited data available from developing countries. This study aimed to assess nutritional status and growth patterns in pediatric CKD patients and evaluate relationships between nutritional parameters and growth outcomes.
Methods: A hospital-based cross-sectional study was conducted at People's College of Medical Sciences & Research Centre, Bhopal, from July to December 2013. One hundred children aged 2-18 years with CKD stages 2-5 (not on dialysis) were enrolled using consecutive sampling. Comprehensive assessment included anthropometric measurements, biochemical analysis, and dietary evaluation using 24-hour recall and food frequency questionnaires. Growth parameters were expressed as Z-scores using WHO standards.
Results: The study population had a mean age of 9.2±4.1 years with 62% males. Growth failure was highly prevalent with 69% having below-normal height-for-age and 45% showing stunting. Malnutrition affected 66% of children, increasing from 44.4% in Stage 2 to 75.0% in Stage 5 CKD. Only 34% met recommended caloric intake and 42% met protein requirements. Strong positive correlations were observed between serum albumin (r=0.64), hemoglobin (r=0.56), energy intake (r=0.48), and height Z-scores. Anemia was universal, and secondary hyperparathyroidism affected all advanced CKD stages. Early disease onset and longer CKD duration were significantly associated with worse growth outcomes.
Conclusion: Children with CKD demonstrate high prevalence of growth failure and malnutrition that worsen with disease progression. Comprehensive nutritional intervention beginning in early CKD stages, addressing dietary inadequacy, anemia, and mineral metabolism disorders, is essential for optimizing growth outcomes in this vulnerable population.
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