Association between insulin growth factor-1, bone mineral density, and frailty phenotype in children with chronic kidney disease

Karava, Vasiliki; Dotis, John; Christoforidis, Athanasios; Liakopoulos, Vassilios; Kondou, Antonia; Tsigaras, Georgios; Tsioni, Konstantina; Kollios, Konstantinos; Printza, Nikoleta

doi:10.1007/s00467-021-04918-y

Cited by 13 publications

(12 citation statements)

References 48 publications

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“…Fatigue is a clinical symptom of frailty. This phenotype has been widely found in the adult population and recently in the pediatric population [14,15]. It is a complex, multifactorial phenomenon which has been defined as 'extreme and persistent tiredness, weakness or exhaustion mental, physical or both' .…”

Section: Discussionmentioning

confidence: 99%

Fatigue assessment and its predictors in pediatric patients with chronic kidney disease stages III to V

Ramadan

Elkoofy

Sabry

et al. 2023

Egypt Pediatric Association Gaz

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Background Chronic fatigue is an intense subjective feeling of mental or physical exhaustion. It influences patients’ daily functioning and quality of life, delays recovery, and increases mortality, especially in chronic kidney disease (CKD) patients. The aim of this study is to assess and determine predictors of chronic fatigue in children with ESRD, dialysis, and pre-dialysis stages that can affect the patients’ quality of life (QOL). Methods We conducted a cross-sectional study on 114 patients diagnosed with CKD stages III to V, following at the nephrology outpatient clinic and hemodialysis (HD) unit of Cairo University Children’s Hospital during the period September 2020 till April 2021. Demographic and laboratory data of patients were gathered, and dialytic analysis in the form of frequency, duration of dialysis sessions, and adequacy of hemodialysis was calculated. The fatigue severity score (FSS) questionnaire was used to assess fatigue’s effects on daily functions, querying its relationship to motivation, physical activity, work, family, and social life. Results The mean age in the current study was (8.8 ± 1.8) years, with 62% being males. The median FSS score was 5.8, with a higher FSS score in stage V CKD patients. High e-GFR, serum sodium, folic acid, and L-carnitine supplementation all reduced the intensity of fatigue, while prolonged HD duration, acidosis, hypertension, and non-compliance to vitamin D replacement increased tiredness severity. Conclusion Routine fatigue assessment and measures to reduce it is a fundamental issue in pediatric CKD patients for better QOL.

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Section: Discussionmentioning

confidence: 99%

Fatigue assessment and its predictors in pediatric patients with chronic kidney disease stages III to V

Ramadan

Elkoofy

Sabry

et al. 2023

Egypt Pediatric Association Gaz

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“…Frailty syndrome is commonly observed in adult CKD patients, with an incidence exceeding 40% in CKD 5D [ 22 ]. Interestingly, this condition has been recently reported in the pediatric CKD population, with a higher frequency in advanced stages, and has been associated with a higher hospitalization rate and lower bone mineral density [ 23 , 24 ]. Therefore, although the literature data are limited, the need arises for the systematic recording of fatigue in CKD pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Fatigue and Quality of Life in Children with Chronic Kidney Disease

et al. 2022

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Background: This study investigates the effect of chronic kidney disease (CKD) stage on fatigue and health-related quality of life (HRQoL) in the pediatric population. Material and Methods: The PedsQL (Pediatric Quality of Life Inventory) Multidimensional Fatigue Scale (subcategories: general, sleep/rest, and cognitive fatigue) and HRQoL Generic Core Scales (subcategories: physical, emotional, social, and school functioning) questionnaires were completed by 30 patients aged from 7 to 18 years old with CKD stage 2–4, CKD stage 5 on dialysis (CKD 5D), and kidney transplantation (KTx), as well as their parents. Results: Both low “Total Fatigue” and “Total HRQoL” scores were reported in 16.7% of patients. “Sleep/Rest Fatigue”, “Emotional Functioning”, and “School functioning” were the lowest scored subcategories. CKD 5D/KTx patients presented lower “Sleep/Rest Fatigue” (p = 0.022) and, more frequently, low “School Functioning” scores (p = 0.029). The “Total HRQoL” score was correlated to the “Total Fatigue” score (rs = 0.625, p < 0.001). A low “Sleep/Rest Fatigue” score was associated with low “Physical Functioning”, “School Functioning”, and “Total HRQoL” scores (p = 0.016, p = 0.001, and p = 0.047 respectively). Parents’ HRQoL score was lower than patients’ score on “Physical Functioning” (p = 0.040) and “School Functioning” subcategories (p = 0.045). Conclusions: Fatigue and disturbed HRQoL are mostly observed in CKD 5D and KTx pediatric patients, and are associated with sleep disorders and school dysfunction. Fatigue affects HRQoL, which is perceived as more deteriorated by the patients’ parents.

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“…The growing body of clinical evidence in CKD pediatric populations underline that muscle wasting is associated with general fatigue, deteriorating life quality, and with decreased exercise capacity, jeopardizing cardiorespiratory fitness [ 54 , 56 , 62 , 63 ]. Moreover, although the muscle–bone unit is impaired in CKD, muscle wasting possibly contributes to bone deficits, resulting in decline of musculoskeletal health [ 56 , 61 , 64 , 65 ]. In clinical studies, reduced muscle strength was correlated to low bone cortical area and section modulus, suggesting that muscle impairment may enhance CKD bone disease [ 61 , 65 ].…”

Section: Muscle Wasting and Outcomes In Children With Ckdmentioning

confidence: 99%

Malnutrition Patterns in Children with Chronic Kidney Disease

Karava

Dotis

Kondou

et al. 2023

Life

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Malnutrition is frequent in children with chronic kidney disease (CKD). Apart from undernutrition and protein energy wasting (PEW), overnutrition prevalence is rising, resulting in fat mass accumulation. Sedentary behavior and unbalanced diet are the most important causal factors. Both underweight and obesity are linked to adverse outcomes regarding renal function, cardiometabolic risk and mortality rate. Muscle wasting is the cornerstone finding of PEW, preceding fat loss and may lead to fatigue, musculoskeletal decline and frailty. In addition, clinical data emphasize the growing occurrence of muscle mass and strength deficits in patients with fat mass accumulation, attributed to CKD-related wasting processes, reduced physical activity and possibly to obesity-induced inflammatory diseases, leading to sarcopenic obesity. Moreover, children with CKD are susceptible to abdominal obesity, resulting from high body fat distribution into the visceral abdomen compartment. Both sarcopenic and abdominal obesity are associated with increased cardiometabolic risk. This review analyzes the pathogenetic mechanisms, current trends and outcomes of malnutrition patterns in pediatric CKD. Moreover, it underlines the importance of body composition assessment for the nutritional evaluation and summarizes the advantages and limitations of the currently available techniques. Furthermore, it highlights the benefits of growth hormone therapy and physical activity on malnutrition management.

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Association between insulin growth factor-1, bone mineral density, and frailty phenotype in children with chronic kidney disease

Cited by 13 publications

References 48 publications

Fatigue assessment and its predictors in pediatric patients with chronic kidney disease stages III to V

Fatigue assessment and its predictors in pediatric patients with chronic kidney disease stages III to V

Fatigue and Quality of Life in Children with Chronic Kidney Disease

Malnutrition Patterns in Children with Chronic Kidney Disease

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