Biochemical Indicators of Malnutrition in Children with Chronic Kidney Disease on Peritoneal Dialysis, Hemodialysis and Post-Transplant Kidney

Abstract

Objectives To demonstrate differences in the profile of biochemical indicators of nutritional status in children with End-stage renal disease (ESRD) between peritoneal dialysis (PD), hemodialysis (HD), and renal transplantation (RT). Methods Analytical cross-sectional study. A total of 130 children and adolescents between 6 and 18 years of age with ESRD were included: 49 children in RT, 33 in PD, and 48 in HD. The biochemical indicators (hemoglobin, glucose, albumin, total cholesterol, and triglycerides) and anthropometric indicators of nutritional status were obtained. ANOVA, T-student, and Pearson correlation were performed. For nonparametric variables, Chi-square, U-Mann Whitney, Kruskal-Wallis, and odds ratio were used. Results The frequency of hypoalbuminemia was higher in the PD group than in the RT group [OR = 56.4 (6.9, 459) P < 0.001] and the HD group [OR = 10.08 (3.1, 319) P < 0.001]. Anemia was higher in the HD group compared with the RT group [OR = 4.9 (2.1, 11.2) P < 0.001] and the PD group [OR = 3.0 (1.3, 7.7), P = 0.02]. Cholesterol serum concentration was higher in the PD group compared to the RT group [OR = 27.4 (3.3, 225), P < 0.01] and the HD group [OR = 26.2 (3.2, 215), P < 0.001]. Patients in the PD group had a higher risk of hypertriglyceridemia than the RT group [OR = 5.5 (1.9, 15.7), P = 0.002] and the HD group [OR = 2.3 (1.1, 5.4), P = 0.04]. Albumin correlated with tricipital skinfold and mid-upper arm circumference (MUAC) in the RT group; with subscapular skinfold (SSF) in the HD group; and with height, SSF, and MUAC in PD group. Conclusions There are substantial differences in the biochemical indicators of nutritional status depending on the renal substitution program. Funding Sources Project supported by the National Council of Science and Technology of Mexico.