scholarly journals Catch-up growth in children with chronic kidney disease started on enteral feeding after 2 years of age

2019 ◽  
Vol 35 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Matko Marlais ◽  
Jelena Stojanovic ◽  
Helen Jones ◽  
Shelley Cleghorn ◽  
Lesley Rees
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Kidney Disease ◽  
Enteral Feeding ◽  
Tube Feeding ◽  
Prepubertal Children ◽  
Enteral Tube Feeding ◽  
Catch Up ◽  
Second Year ◽  
First Time

Abstract Background Enteral feeding by tube in chronic kidney disease (CKD) before 2 years of age improves growth. Whether it is effective after this age is unknown. We assessed whether height and weight SDS changed after tube feeding was started in children with CKD above 2 years of age. Methods Retrospective study of pre-transplant, pre-pubertal children (< 11 years) with CKD stages 2–5 started on nasogastric tube or gastrostomy feeds for the first time after age 2 years. Children were identified by searching dietetic records and the renal database. Children on growth hormone were excluded. Height, weight, and BMI were documented 1 year prior to and at the start of tube feeds, and after 1 and 2 years. Data collection ceased at transplantation. Results Fifty children (25 male) were included. The median (range) age at start of tube feeds was 5.6 (2.1–10.9) years. Sixteen children were dialysed (1 haemodialysis, 15 peritoneal dialysis); 34 predialysis patients had a median (range) eGFR of 22 (6–88) ml/min/1.73 m2. Overall height SDS (Ht SDS) improved from − 2.39 to − 2.27 at 1 year and − 2.18 after 2 years (p = 0.02). BMI SDS improved from − 0.72 to 0.23 after 1 year and was 0.09 after 2 years of enteral feeding (p < 0.0001). Height SDS improved more in children aged 2–6 years (− 2.13 to − 1.68, p = 0.03) and in children not on dialysis (− 2.33 to − 1.99, p = 0.002). Conclusions Enteral tube feeding commenced after 2 years of age in prepubertal children with CKD improves height and weight SDS, with stability of BMI during the second year. Younger children and those not on dialysis had the greatest benefit.

scholarly journals Delivery of a nutritional prescription by enteral tube feeding in children with chronic kidney disease stages 2–5 and on dialysis—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

2020 ◽  
Vol 36 (1) ◽  
pp. 187-204
Author(s):  
Lesley Rees ◽  
◽  
Vanessa Shaw ◽  
Leila Qizalbash ◽  
Caroline Anderson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Growth Parameters ◽  
Tube Feeding ◽  
Low Grade ◽  
Enteral Tube Feeding ◽  
Practice Recommendations ◽  
The Individual ◽  
Disease Stages

AbstractThe nutritional prescription (whether in the form of food or liquid formulas) may be taken orally when a child has the capacity for spontaneous intake by mouth, but may need to be administered partially or completely by nasogastric tube or gastrostomy device (“enteral tube feeding”). The relative use of each of these methods varies both within and between countries. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) based on evidence where available, or on the expert opinion of the Taskforce members, using a Delphi process to seek consensus from the wider community of experts in the field. We present CPRs for delivery of the nutritional prescription via enteral tube feeding to children with chronic kidney disease stages 2–5 and on dialysis. We address the types of enteral feeding tubes, when they should be used, placement techniques, recommendations and contraindications for their use, and evidence for their effects on growth parameters. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgement. Research recommendations have been suggested. The CPRs will be regularly audited and updated by the PRNT.

Efficacy of Growth Hormone Treatment in Children With Chronic Kidney Disease: Tunisian Experience

2021 ◽  
Vol 58 (12) ◽  
pp. 1140-1142
Author(s):  
Abir Boussetta ◽  
R. Laamouri ◽  
M. Jellouli ◽  
O. Naija ◽  
T. Gargah
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Kidney Disease ◽  
Growth Hormone Treatment ◽  
Hormone Treatment

Endocrine Aspects of Kidney Disease

2020 ◽  
Author(s):  
Marcin Adamczak ◽  
Piotr Kuczera ◽  
Andrzej Wiecek
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Serum Prolactin ◽  
Clinical Consequences ◽  
Synthesis And Degradation ◽  
Insulin Like Growth Factors

Kidneys play the major role in the synthesis and degradation of several hormones. Different coexisting conditions such as inflammation, malnutrition and metabolic acidosis and applied treatment may also cause endocrine abnormalities in chronic kidney disease (CKD) patients. A tendency towards decreased thyroxin and triiodothyronine with normal serum concentrations of reversed triiodothyronine (as opposed to other chronic non-thyroid, non-kidney diseases) and thyroid stimulating hormone are observed. As far as the somatotopic axis is concerned, in CKD normal serum concentration of growth hormone and its effector – the insulin-like growth factor are observed. Nevertheless, due to the phenomenon of GH/IGF-1 “resistance” CKD patients usually present a phenotype resembling GH deficiency. Serum prolactin concentrations are often elevated in CKD women and men. This leads to the dysregulation of the pituitary-gonadal axis causing hypogonadism and it’s clinical consequences regardless of patient’s gender. The alterations in hormones of gonadal origin caused by uremia, together with hyperprolactinemia lead to the development of sexual dysfunction and infertility in men and women. The alterations of thyroid, pituitary gland and gonads associated with CKD are discussed in this chapter. This review contains 4 tables, and 64 references. Keywords: chronic kidney disease, hypothyroidism, hyperthyroidism, growth hormone, recombinant human GH, insulin-like growth factors, hemodialysis

Growth hormone and chronic kidney disease

2019 ◽  
Vol 28 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Anil K. Pasupulati ◽  
Ram K. Menon
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Kidney Disease

scholarly journals Growth Hormone and Insulin-Like Growth Factor Dysregulation in Pediatric Chronic Kidney Disease

2021 ◽  
pp. 1-10
Author(s):  
Denver D. Brown ◽  
Andrew Dauber
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Growth Factor ◽  
Kidney Disease ◽  
Common Finding ◽  
Insulin Like Growth Factor ◽  
Contributing Factors ◽  
Poor Growth ◽  
Negative Effect ◽  
Pediatric Ckd

Poor growth is a common finding in children with chronic kidney disease (CKD) that has been associated with poor long-term outcomes. The etiology of poor growth in this population is multifactorial and includes dysregulation of the growth hormone (GH) and insulin-like growth factor (IGF) axis. In this review, we describe the data on GH resistance or insensitivity and inappropriate levels or reduced bioactivity of IGF proposed as contributing factors of growth impairment in children with CKD. Additionally, we describe the theorized negative effect of metabolic acidosis, another frequent finding in pediatric CKD, on the GH/IGF axis and growth. Last, we present the current and potential therapies for the treatment of short stature in pediatric CKD that target the GH/IGF hormonal axis.

scholarly journals The Effect of Enteral Tube Feeding on Patients’ Health-Related Quality of Life: A Systematic Review

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1046 ◽  
Author(s):  
Omorogieva Ojo ◽  
Edel Keaveney ◽  
Xiao-Hua Wang ◽  
Ping Feng
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Enteral Feeding ◽  
Tube Feeding ◽  
Future Research ◽  
Measuring Instruments ◽  
Medical Subject Headings ◽  
Enteral Tube Feeding ◽  
Significant Difference

Patients with functional gastrointestinal tract who are unable to meet their nutritional requirements may benefit from the use of enteral nutrition via feeding tubes which could be nasogastric, percutaneous endoscopic gastrostomy and jejunostomy. Although enteral tube feeding has been shown to promote nutritional status, improve wound healing, and enhance patients’ quality of life (QoL), evidence of tube and feed complications and reduced QoL has also been reported. Despite the increasing prevalence of patients on enteral tube feeding, no systematic review examining the role of enteral tube feeding on patients’ QoL appears to have been published. Aim: The aim of this systematic review is to evaluate the effect of enteral tube feeding on patients’ QoL. Method: Three databases (EMBASE, Pubmed, and PsycINFO) plus Google Scholar were searched for relevant articles based on the Population, Intervention, Comparator, Outcomes (PICO) framework. The review was in line with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and involved the use of synonyms and medical subject headings. In addition, search terms were combined using Boolean operators (AND/OR) and all the articles retrieved were exported to EndNote for de-duplication. Results: Fourteen articles which met the criteria were included and three distinct areas were identified: the effect of early versus late enteral tube feeding on QoL; the QoL of patients on gastrostomy versus standard care, and the effect of enteral tube feeding on QoL. Overall, nine studies reported improvement in the QoL of patients on enteral tube feeding, while five studies demonstrated either no significant difference or reduction in QoL. Some factors which may have influenced these outcomes are differences in types of gastrostomy tubes, enteral feeding methods (including time patients spent connected to enteral feed/pump), and patients’ medical conditions, as well as the generic and/or type of QoL measuring instrument used. Conclusion: Most reviewed studies suggest that enteral tube feeding is effective in improving patients’ QoL. The use of enteral tube feeding-specific QoL measuring instruments is recommended for future research, and improved management strategies including use of mobile enteral feeding pumps should further enhance patients’ QoL. More studies on the effect of delivery systems/enteral feeding pumps on QoL are needed as research in this area is limited.

Patterns of recombinant growth hormone therapy use and growth responses among children with chronic kidney disease

2021 ◽  
Author(s):  
Derek K. Ng ◽  
Megan K. Carroll ◽  
Frederick J. Kaskel ◽  
Susan L. Furth ◽  
Bradley A. Warady ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Growth Hormone ◽  
Kidney Disease ◽  
Hormone Therapy ◽  
Growth Hormone Therapy ◽  
Growth Responses ◽  
Recombinant Growth Hormone
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