Global Variation of Nutritional Status in Children Undergoing Chronic Peritoneal Dialysis: A Longitudinal Study of the International Pediatric Peritoneal Dialysis Network

International Pediatric Peritoneal Dialysis Network (IPPN) Registry

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was most prevalent in South and Southeast Asia (20%), Central Europe (16.7%) and Turkey (15.2%), whereas overweight and obesity were most common in the Middle East (40%) and the US (33%). BMI SDS at PD initiation was associated positively with current eGFR and gastrostomy feeding prior to PD start. Over the course of PD BMI SDS tended to increase on CPD in underweight and normal weight children, whereas it decreased in initially overweight patients. In infancy, mortality risk was amplified by obesity, whereas in older children mortality was markedly increased in association with underweight. Both underweight and overweight are prevalent in pediatric ESKD, with the prevalence varying across the globe. Late dialysis start is associated with underweight, while enteral feeding can lead to obesity. Nutritional abnormalities tend to attenuate with time on dialysis. Mortality risk appears increased with obesity in infants and with underweight in older children.

Original languageEnglish (US)
Article number4886
JournalScientific reports
Volume9
Issue number1
DOIs
StatePublished - Dec 1 2019

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Thinness
Peritoneal Dialysis
Nutritional Status
Longitudinal Studies
Pediatrics
Obesity
Body Mass Index
Chronic Kidney Failure
Dialysis
Child Mortality
Southeastern Asia
Gastrostomy
Middle East
Mortality
Pediatric Obesity
Anorexia
Enteral Nutrition
Turkey
Registries
Weights and Measures

ASJC Scopus subject areas

  • General

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Global Variation of Nutritional Status in Children Undergoing Chronic Peritoneal Dialysis : A Longitudinal Study of the International Pediatric Peritoneal Dialysis Network. / International Pediatric Peritoneal Dialysis Network (IPPN) Registry.

In: Scientific reports, Vol. 9, No. 1, 4886, 01.12.2019.

Research output: Contribution to journalArticle

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title = "Global Variation of Nutritional Status in Children Undergoing Chronic Peritoneal Dialysis: A Longitudinal Study of the International Pediatric Peritoneal Dialysis Network",
abstract = "While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9{\%} and 19.7{\%}, respectively. Underweight was most prevalent in South and Southeast Asia (20{\%}), Central Europe (16.7{\%}) and Turkey (15.2{\%}), whereas overweight and obesity were most common in the Middle East (40{\%}) and the US (33{\%}). BMI SDS at PD initiation was associated positively with current eGFR and gastrostomy feeding prior to PD start. Over the course of PD BMI SDS tended to increase on CPD in underweight and normal weight children, whereas it decreased in initially overweight patients. In infancy, mortality risk was amplified by obesity, whereas in older children mortality was markedly increased in association with underweight. Both underweight and overweight are prevalent in pediatric ESKD, with the prevalence varying across the globe. Late dialysis start is associated with underweight, while enteral feeding can lead to obesity. Nutritional abnormalities tend to attenuate with time on dialysis. Mortality risk appears increased with obesity in infants and with underweight in older children.",
author = "{International Pediatric Peritoneal Dialysis Network (IPPN) Registry} and Franz Schaefer and Laura Benner and Dagmara Borzych-Dużałka and Joshua Zaritsky and Hong Xu and Lesley Rees and Antonio, {Zenaida L.} and Erkin Serdaroglu and Nakysa Hooman and Hiren Patel and Lale Sever and Karel Vondrak and Joseph Flynn and Anabella R{\'e}bori and William Wong and Tuula H{\"o}ltt{\"a} and Yildirim, {Zeynep Yuruk} and Bruno Ranchin and Ryszard Grenda and Sara Testa and Dorota Drożdz and Szabo, {Attila J.} and Loai Eid and Biswanath Basu and Renata Vitkevic and Cynthia Wong and Pottoore, {Stephen J.} and Dominik M{\"u}ller and Ruhan Dusunsel and Celedon, {Claudia Gonzalez} and Marc Fila and Lisa Sartz and Anja Sander and Warady, {Bradley A.} and M. Adragna and Coccia, {P. A.} and A. Suarez and Valles, {P. G.} and R. Salim and L. Alconcher and K. Arbeiter and {van Hoeck}, K. and V. Koch and J. Feber and E. Harvey and C. White and M. Valenzuela and J. Villagra and F. Cano and S. Sethi",
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AU - International Pediatric Peritoneal Dialysis Network (IPPN) Registry

AU - Schaefer, Franz

AU - Benner, Laura

AU - Borzych-Dużałka, Dagmara

AU - Zaritsky, Joshua

AU - Xu, Hong

AU - Rees, Lesley

AU - Antonio, Zenaida L.

AU - Serdaroglu, Erkin

AU - Hooman, Nakysa

AU - Patel, Hiren

AU - Sever, Lale

AU - Vondrak, Karel

AU - Flynn, Joseph

AU - Rébori, Anabella

AU - Wong, William

AU - Hölttä, Tuula

AU - Yildirim, Zeynep Yuruk

AU - Ranchin, Bruno

AU - Grenda, Ryszard

AU - Testa, Sara

AU - Drożdz, Dorota

AU - Szabo, Attila J.

AU - Eid, Loai

AU - Basu, Biswanath

AU - Vitkevic, Renata

AU - Wong, Cynthia

AU - Pottoore, Stephen J.

AU - Müller, Dominik

AU - Dusunsel, Ruhan

AU - Celedon, Claudia Gonzalez

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AU - Sartz, Lisa

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AU - Warady, Bradley A.

AU - Adragna, M.

AU - Coccia, P. A.

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AU - Valles, P. G.

AU - Salim, R.

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AU - Arbeiter, K.

AU - van Hoeck, K.

AU - Koch, V.

AU - Feber, J.

AU - Harvey, E.

AU - White, C.

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AU - Villagra, J.

AU - Cano, F.

AU - Sethi, S.

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N2 - While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was most prevalent in South and Southeast Asia (20%), Central Europe (16.7%) and Turkey (15.2%), whereas overweight and obesity were most common in the Middle East (40%) and the US (33%). BMI SDS at PD initiation was associated positively with current eGFR and gastrostomy feeding prior to PD start. Over the course of PD BMI SDS tended to increase on CPD in underweight and normal weight children, whereas it decreased in initially overweight patients. In infancy, mortality risk was amplified by obesity, whereas in older children mortality was markedly increased in association with underweight. Both underweight and overweight are prevalent in pediatric ESKD, with the prevalence varying across the globe. Late dialysis start is associated with underweight, while enteral feeding can lead to obesity. Nutritional abnormalities tend to attenuate with time on dialysis. Mortality risk appears increased with obesity in infants and with underweight in older children.

AB - While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was most prevalent in South and Southeast Asia (20%), Central Europe (16.7%) and Turkey (15.2%), whereas overweight and obesity were most common in the Middle East (40%) and the US (33%). BMI SDS at PD initiation was associated positively with current eGFR and gastrostomy feeding prior to PD start. Over the course of PD BMI SDS tended to increase on CPD in underweight and normal weight children, whereas it decreased in initially overweight patients. In infancy, mortality risk was amplified by obesity, whereas in older children mortality was markedly increased in association with underweight. Both underweight and overweight are prevalent in pediatric ESKD, with the prevalence varying across the globe. Late dialysis start is associated with underweight, while enteral feeding can lead to obesity. Nutritional abnormalities tend to attenuate with time on dialysis. Mortality risk appears increased with obesity in infants and with underweight in older children.

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