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Catch-up growth in children with chronic kidney disease started on enteral feeding after 2 years of age

Marlais, M; Stojanovic, J; Jones, H; Cleghorn, S; Rees, L; (2020) Catch-up growth in children with chronic kidney disease started on enteral feeding after 2 years of age. Pediatric Nephrology , 35 (1) pp. 113-118. 10.1007/s00467-019-04382-9. Green open access

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Abstract

BACKGROUND: Enteral feeding by tube in chronic kidney disease (CKD) before 2 years of age improves growth. Whether it is effective after this age is unknown. We assessed whether height and weight SDS changed after tube feeding was started in children with CKD above 2 years of age. METHODS: Retrospective study of pre-transplant, pre-pubertal children (< 11 years) with CKD stages 2–5 started on nasogastric tube or gastrostomy feeds for the first time after age 2 years. Children were identified by searching dietetic records and the renal database. Children on growth hormone were excluded. Height, weight, and BMI were documented 1 year prior to and at the start of tube feeds, and after 1 and 2 years. Data collection ceased at transplantation. RESULTS: Fifty children (25 male) were included. The median (range) age at start of tube feeds was 5.6 (2.1–10.9) years. Sixteen children were dialysed (1 haemodialysis, 15 peritoneal dialysis); 34 predialysis patients had a median (range) eGFR of 22 (6–88) ml/min/1.73 m2. Overall height SDS (Ht SDS) improved from − 2.39 to − 2.27 at 1 year and − 2.18 after 2 years (p = 0.02). BMI SDS improved from − 0.72 to 0.23 after 1 year and was 0.09 after 2 years of enteral feeding (p < 0.0001). Height SDS improved more in children aged 2–6 years (− 2.13 to − 1.68, p = 0.03) and in children not on dialysis (− 2.33 to − 1.99, p = 0.002). CONCLUSIONS: Enteral tube feeding commenced after 2 years of age in prepubertal children with CKD improves height and weight SDS, with stability of BMI during the second year. Younger children and those not on dialysis had the greatest benefit.

Type: Article
Title: Catch-up growth in children with chronic kidney disease started on enteral feeding after 2 years of age
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00467-019-04382-9
Publisher version: https://doi.org/10.1007/s00467-019-04382-9
Language: English
Additional information: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
Keywords: Pediatrics, Urology & Nephrology, Paediatrics, Chronic kidney disease, Growth, Enteral feeding, Gastrostomy
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10090515
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