Utility of muscle ultrasound in nutritional assessment of children with nephrotic syndrome

Abstract

Background Nutritional status assessment in children with nephrotic syndrome (NS) is critical for identifying patients who are at risk of protein-energy wasting (PEW) and for determining their nutritional needs and monitoring nutritional intervention outcomes. Methods In a case–control study, we enrolled 40 children (age range: 2–16 years) with NS and 40 apparently healthy children (age and sex-matched) as a control group. Anthropometric data, as well as demographic, clinical, and laboratory data, were collected. A dietary intake assessment using a 3-day food intake record was done, and the quadriceps rectus femoris thickness (QRFT) and quadriceps vastus intermedius thickness (QVIT) were assessed using B-mode ultrasound and compared between both groups. Results Children with NS had lower QRFT and QVIT measurements than control groups (p < 0.001). Inadequacy in protein intake occurred in 62.5% and 27.5% of the NS and control groups, respectively (p = 0.002). The thickness of the rectus and vastus muscles by ultrasound was significantly associated with the percentage of protein intake (p < 0.001). The ROC curve revealed that the best cutoff value of QRFT for the prediction of the patient at risk of malnutrition was ≤ 1.195 with an area under curve of 0.907, with p < 0.001. Conclusion In children with NS, skeletal muscle ultrasound is a simple and easy-to-use bedside technique for the identification of patients at risk of malnutrition. Graphical abstract

Characteristics of Accidental Falls in the Patients with Chronic Kidney Diseases: A 14-Year Retrospective Study and Review

“…For example, type 2 diabetes causes reduced cognitive function, muscle strength, and level of performance capacity 21-23 . Studies based on childhood nephrotic syndrome have shown that nephrotic syndrome predisposes children to malnutrition, putting them at risk for growth retardation, muscle wasting, and cognitive impairment 24, 25 . Similarly, clinical adult studies have shown that ESKD patients on hemodialysis have significantly less nutritional status and muscle mass than healthy groups 26 .…”

“…For example, type 2 diabetes causes reduced cognitive function, muscle strength, and level of performance capacity [21][22][23] . Studies based on childhood nephrotic syndrome have shown that nephrotic syndrome predisposes children to malnutrition, putting them at risk for growth retardation, muscle wasting, and cognitive impairment 24,25 .…”