A study of 121 Aboriginal and 91 non-Aboriginal children aged 6 years and under was carried out in Bourke during 6 months of 1986. These children were selected either because they were admitted to hospital and had an incidental blood test or were screened at various childcare and preschool facilities in the town. A haemoglobin level of below 100 gll was found in 12.4% of Aboriginal children compared with only 3.3% of non-Aboriginal children. A mean corpuscular volume of less than 80 was found in 15.7% of Aboriginal children and 3.3% of nowAboriginal children. Of the total sample, 17.4% of Aboriginal children and 6.6% of non-Aboriginal children had a serum ferritin level of less than 10 nglml. These markers of iron deficiency were associated with low weight and crowded living conditions in Aboriginal children. The prevalence of haemoglobin below 100 gll among Aboriginal children under 5 years has fallen from 24.7% in 1971 to 14.1% in 1986.
Both overnutrition resulting in obesity and undernutrition leading to protein energy wasting contribute to chronic kidney disease-related morbidity and adverse outcomes. Early in the course of chronic kidney disease, goals should be set for a healthy body weight and lifelong efforts should be encouraged to attain and keep this goal. For patients with progressive chronic kidney disease, the development of weight loss and protein energy wasting is an ominous sign and is a clinical signal for a myriad of adverse catabolic processes that have been associated with poor outcomes including hospitalization and death, particularly for those with end-stage renal disease. Renal nutrition consultation at all stages of chronic kidney disease with frequent visits and education and counselling is needed to intercede early in both ends of the nutrition continuum in patients with chronic kidney disease.
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