Prevalence of renal abnormality in pediatric intestinal failure

Kosar, Christina; Silva, Nicole de; Avitzur, Yaron; Steinberg, Karen K.; Courtney‐Martin, Glenda; Chambers, Kathryn; Fitzgerald, Kevin T.; Harvey, Elizabeth; Wales, Paul W.

doi:10.1016/j.jpedsurg.2016.02.025

Cited by 15 publications

(32 citation statements)

References 28 publications

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“…Renal impairment has been reported to occur in 30–56% of long‐term PN patients using an estimated glomerular filtration rate (GFR) . However, the estimated GFR underappreciates true renal function as creatinine is a poor marker of renal function, especially in the early stages of renal damage, even more in presence of low lean body mass. Cystatin C is not related to muscle mass and may be a better indicator of renal function .…”

Section: Monitoring Of Long‐term Complicationsmentioning

confidence: 99%

“…Main factors include prolonged dehydration, sepsis, hemodynamic instability episodes, nephrotoxic agents, hyperoxaluria, and prematurity. PN‐related factors include potential cyclical dehydration induced by cyclical PN, promotion of renal stones by acidity of PN solution, and presence of vitamin C and potential chromium and aluminum toxicity . Moukarzel et al .…”

Section: Monitoring Of Long‐term Complicationsmentioning

confidence: 99%

“…Monitoring includes serum creatinine and urea (every 1–3 months) and Cystatin C (every 6 months). Urine tests include protein, calcium, oxalate, and creatinine . Urine results may vary depending on the timing of tests.…”

Section: Monitoring Of Long‐term Complicationsmentioning

confidence: 99%

“…Nocturnal hypercalciuria has been reported with cyclical PN and with high amino acids and sodium concentrations . Ideally, paired urine and blood samples are obtained as far as possible from the end of the cyclical PN . We suggest monitoring aluminum and chromium levels annually .…”

Section: Monitoring Of Long‐term Complicationsmentioning

confidence: 99%

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Monitoring of long‐term parenteral nutrition in children with intestinal failure

Zemrani

Bines

2019

JGH Open

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Pediatric intestinal failure (IF) is a rare and complex condition associated with significant morbidity and mortality. It is defined as the reduction of gut mass or function below the minimal needed for absorption of nutrients and fluid to sustain life and growth. Since the advent of specialized multidisciplinary intestinal rehabilitation centers, IF management has considerably evolved in the last years, but serious complications of long‐term parenteral nutrition (PN) can occur. Main complications include intestinal failure‐associated liver disease, growth failure, body composition imbalance, central venous access complications, micronutrient deficiencies and toxicities, metabolic bone disease, small intestinal bacterial overgrowth, and renal disease. With improvement in survival rates of patients over the last 20 years, emphasis should be on limiting IF‐related comorbidities and improving quality of life. Close monitoring is pivotal to ensuring quality of care of these patients. The care of children with chronic IF should involve a comprehensive monitoring plan with flexibility for individualization according to specific patient needs. Monitoring of children on long‐term PN varies significantly across units and is mainly based on experience, although few guidelines exist. This narrative review summarizes the current knowledge and practices related to monitoring of children with IF. The authors also share their 20‐year experience at the Royal Children's Hospital in Melbourne Australia on this topic.

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Section: Monitoring Of Long‐term Complicationsmentioning

confidence: 99%

Section: Monitoring Of Long‐term Complicationsmentioning

confidence: 99%

Section: Monitoring Of Long‐term Complicationsmentioning

confidence: 99%

Section: Monitoring Of Long‐term Complicationsmentioning

confidence: 99%

See 2 more Smart Citations

Monitoring of long‐term parenteral nutrition in children with intestinal failure

Zemrani

Bines

2019

JGH Open

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“…While multidisciplinary care and survival for patients with SBS have improved over time, the morbidity and burden of disease remain substantial. SBS associated complications including intestinal failure associated liver disease (IFALD), small bowel bacterial overgrowth (SBBO), nephrocalcinosis, cholelithiasis, and metabolic bone disease (MBD) are quite prevalent in this patient population [5][6][7][8][9]. A high resource and disease burden is also reported in children with SBS after initial discharge and in younger children with SBS [10][11][12].…”

mentioning

confidence: 98%

Long-Term Outcomes and Disease Burden of Neonatal Onset Short Bowel Syndrome

Han

Knell

Henry

et al. 2020

Journal of Pediatric Surgery

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Combined use of creatinine and cystatin C improves the detection of renal dysfunction in children undergoing home parenteral nutrition

Matrat

Ruiz

Ecochard-Dugelay

et al. 2021

J Parenter Enteral Nutr

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Background Renal dysfunction can complicate home parenteral nutrition (HPN). The aims were, in the context of pediatric HPN, to assess renal function using the measured glomerular filtration rate (mGFR), determine the most accurate formula(s) to estimate GFR, and identify possible underlying mechanisms of renal impairment. Methods A retrospective study was performed in 2 centers. Patients receiving HPN and aged 2–16 years without medical history of nephropathy were included. GFR was measured using iohexol clearance. Estimated GFR (eGFR) was calculated using creatinine, cystatin C–based, and combined (eGFRcr+cyst) Schwartz formulas. Results A total of 36 patients (18 females) were included; they received HPN for 8 (2–16) years. The primary digestive disease was short‐bowel syndrome for 16 (44%) patients, gastrointestinal motility disorder for 10 (28%), or congenital diarrhea for 10 (28%). The median (range) mGFR was 99 (33–136) ml/min/1.73 m2; 9 (25%) patients had mildly decreased mGFR (<90 and ≥60 ml/min/1.73 m2), and 2 (6%) had mildly to severely decreased mGFR (<60 ml/min/1.73 m2). The eGFRcr+cyst formula was the most accurate and precise to estimate GFR. A significant negative correlation between mGFR and PN duration was found for patients receiving PN for 6–7/7 days (P = .008). Activation of the renin‐angiotensin system was identified in 15 of 36 (42%) patients. Conclusion Renal dysfunction was frequent and correlated with the duration of PN only for patients with the most severe intestinal failure. The use of eGFRcr+cyst improves its detection in these patients. Chronic dehydration may be an underlying mechanism.

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Prevalence of renal abnormality in pediatric intestinal failure

Cited by 15 publications

References 28 publications

Monitoring of long‐term parenteral nutrition in children with intestinal failure

Monitoring of long‐term parenteral nutrition in children with intestinal failure

Long-Term Outcomes and Disease Burden of Neonatal Onset Short Bowel Syndrome

Combined use of creatinine and cystatin C improves the detection of renal dysfunction in children undergoing home parenteral nutrition

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