Bone Mineral Disorders in Children with Predialysis Chronic Kidney Disease Correlates with Short Stature

Authors

  • Ghina Rania Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Henny Adriani Puspitasari Nephrology Division, Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Eka Laksmi Hidayati Nephrology Division, Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Cut Nurul Hafifah Nutrition and Metabolic Diseases Division, Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

DOI:

https://doi.org/10.58427/apghn.3.1.2024.12-23

Keywords:

children, chronic kidney disease, nutritional status, pre-dialysis, influential factors  

Abstract

Background: The increasing prevalence of malnutrition and growth impairment among children with CKD could impact the prognosis and the preferred intervention. Therefore, this study aimed to identify the nutritional status of children with CKD and its relating factors.

Method: A cross-sectional study was conducted in a tertiary, national-referral teaching hospital in Jakarta. Sociodemographic and laboratory data were obtained from medical records. Body weight and height of participants were measured using digital scale and stadiometer, respectively. Growth and nutritional status indicators such as BMI-for-age, weight-for-height, height for age, and weight for age were quantified and plotted using WHO Anthro and Anthroplus application.

Result: A total of 18 participants aged 3-17 years old with CKD stage 3 – 5 were included in this study. BMI measurements showed a z-score average of -1.02, while the mean z-score for height-for-age was of -2.71. Our study demonstrated a significant association between the height-for-age and mineral bone in children with CKD (p = 0.005). However, we found no association between mineral bone disorder with other indicators of nutritional status. Furthermore, our study also found no significant relation between nutritional status and other influencing factors including the stage of CKD, duration of CKD, age, gender, primary etiological factor, hypertension, anemia, age, familial economic status, disease duration, and parental education level demonstrates no significant correlation (p > 0.05).

Conclusion: Children with stage 3 – 5 CKD in the pre-dialysis phase are shown to be underweight and short statured but with normal nutritional status. Mineral bone disorder was revealed to be significantly associated with height-for-age in children with CKD.

References

Lv JC, Zhang LX. Prevalence and Disease Burden of Chronic Kidney Disease. Adv Exp Med Biol. 2019;1165:3-15.https://doi.org/10.1007/978-981-13-8871-2_1. DOI: https://doi.org/10.1007/978-981-13-8871-2_1

Direktorat Jenderal Pencegahan dan Pengendalian Penyakit Kementerian Kesehatan RI. Peran pemerintah dalam pencegahan dan pengendalian gangguan ginjal anak. Jakarta: Kementerian Kesehatan Republik Indonesia 2018.

Iorember FM. Malnutrition in Chronic Kidney Disease. Front Pediatr. 2018;6:161.https://doi.org/10.3389/fped.2018.00161. DOI: https://doi.org/10.3389/fped.2018.00161

Panggabean MS. Nutrisi Pasien Anak dengan Chronic Kidney Disease (CKD). Cermin Dunia Kedokteran. 2022;49(6):320-6.https://doi.org/10.55175/cdk.v49i6.240. DOI: https://doi.org/10.55175/cdk.v49i6.240

Anupama SH, Abraham G, Alex M, Vijayan M, Subramanian KK, Fernando E, et al. A multicenter study of malnutrition status in chronic kidney disease stages I-V-D from different socioeconomic groups. Saudi J Kidney Dis Transpl. 2020;31(3):614-23.https://doi.org/10.4103/1319-2442.289448. DOI: https://doi.org/10.4103/1319-2442.289448

Oluseyi A, Enajite O. Malnutrition in pre-dialysis chronic kidney disease patients in a teaching hospital in Southern Nigeria. Afr Health Sci. 2016;16(1):234-41.https://doi.org/10.4314/ahs.v16i1.31. DOI: https://doi.org/10.4314/ahs.v16i1.31

Sozeri B, Mir S, Kara O, Dincel N. Growth impairment and nutritional status in children with chronic kidney disease. Iran J Pediatr. 2011;21:271-7.

Meza K, Biswas S, Zhu YS, Gajjar A, Perelstein E, Kumar J, et al. Tumor necrosis factor-alpha is associated with mineral bone disorder and growth impairment in children with chronic kidney disease. Pediatr Nephrol. 2021;36(6):1579-87.https://doi.org/10.1007/s00467-020-04846-3. DOI: https://doi.org/10.1007/s00467-020-04846-3

Metasyah N, Hidayati EL. Nutritional Status in Children with End-Stage Kidney Disease Undergoing Hemodialysis and Other Related Factors. Arch Pediatr Gastr Hepatol Nutr. 2023;2(3):13-24.https://doi.org/10.58427/apghn.2.3.2023.13-24 DOI: https://doi.org/10.58427/apghn.2.3.2023.13-24

Amirah P, Puspitasari HA, Hafifah CN.Analysis of the Impact of Continuous Ambulatory Peritoneal Dialysis on Nutritional Status in Pediatric Chronic Kidney Disease. Arch Pediatr Gastr Hepatol Nutr. 2023;2(4).1-10.https://doi.org/10.58427/apghn.2.4.2023.1-10 DOI: https://doi.org/10.58427/apghn.2.4.2023.1-10

Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia No. 2 Tahun 2020. Jakarta: Kementerian Kesehatan Republik Indonesia; 2020.

Silva VR, Soares CB, Magalhaes JO, de Barcelos IP, Cerqueira DC, Simoes e Silva AC, et al. Anthropometric and biochemical profile of children and adolescents with chronic kidney disease in a predialysis pediatric interdisciplinary program. ScientificWorldJournal. 2015;2015:810758.https://doi.org/10.1155/2015/810758. DOI: https://doi.org/10.1155/2015/810758

Gao T, Leonard MB, Zemel B, Kalkwarf HJ, Foster BJ. Interpretation of body mass index in children with CKD. Clin J Am Soc Nephrol. 2012;7(4):558-64.https://doi.org/10.2215/CJN.09710911. DOI: https://doi.org/10.2215/CJN.09710911

Rodig NM, McDermott KC, Schneider MF, Hotchkiss HM, Yadin O, Seikaly MG, et al. Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children Study. Pediatr Nephrol. 2014;29(10):1987-95.https://doi.org/10.1007/s00467-014-2812-9. DOI: https://doi.org/10.1007/s00467-014-2812-9

Greenbaum LA, Munoz A, Schneider MF, Kaskel FJ, Askenazi DJ, Jenkins R, et al. The association between abnormal birth history and growth in children with CKD. Clin J Am Soc Nephrol. 2011;6(1):14-21.https://doi.org/10.2215/CJN.08481109. DOI: https://doi.org/10.2215/CJN.08481109

Hamasaki Y, Ishikura K, Uemura O, Ito S, Wada N, Hattori M, et al. Growth impairment in children with pre-dialysis chronic kidney disease in Japan. Clin Exp Nephrol. 2015;19(6):1142-8.https://doi.org/10.1007/s10157-015-1098-y. DOI: https://doi.org/10.1007/s10157-015-1098-y

Yaya S, Uthman OA, Kunnuji M, Navaneetham K, Akinyemi JO, Kananura RM, et al. Does economic growth reduce childhood stunting? A multicountry analysis of 89 Demographic and Health Surveys in sub-Saharan Africa. BMJ Glob Health. 2020;5(1):e002042.https://doi.org/10.1136/bmjgh-2019-002042. DOI: https://doi.org/10.1136/bmjgh-2019-002042

Hogan J, Schneider MF, Pai R, Denburg MR, Kogon A, Brooks ER, et al. Grip strength in children with chronic kidney disease. Pediatr Nephrol. 2020;35(5):891-9.https://doi.org/10.1007/s00467-019-04461-x. DOI: https://doi.org/10.1007/s00467-019-04461-x

Pietrobelli A, Agosti M, MeNu G. Nutrition in the First 1000 Days: Ten Practices to Minimize Obesity Emerging from Published Science. Int J Environ Res Public Health. 2017;14(12).https://doi.org/10.3390/ijerph14121491. DOI: https://doi.org/10.3390/ijerph14121491

World Health Organization. Adolescent nutrition: a review of the situation in selected south-east asian countries. New Delhi: WHO; 2006.

Badan Penyelenggara Jaminan Sosial Kesehatan. Panduan Layanan Bagi Peserta Jaminan Kesehatan Nasional Kartu Indonesia Sehat (JKN-KIS). Jakarta: BPJS Kesehatan; 2022.

Badan Pengawas Obat dan Makanan Republik Indonesia. Peraturan Badan Pengawas Obat dan Makanan Nomor 1 Tahun 2018 Tentang Pengawasan Pangan Olahan Untuk Keperluan Gizi Khusus. Jakarta: BPOM; 2018.

Alderman H, Headey DD. How Important is Parental Education for Child Nutrition? World Dev. 2017;94:448-64.https://doi.org/10.1016/j.worlddev.2017.02.007. DOI: https://doi.org/10.1016/j.worlddev.2017.02.007

Flynn JT, Mitsnefes M, Pierce C, Cole SR, Parekh RS, Furth SL, et al. Blood pressure in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children study. Hypertension. 2008;52(4):631-7.https://doi.org/10.1161/HYPERTENSIONAHA.108.110635. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.108.110635

Erlianda D, Rizal MF. Pertumbuhan Dan Perkembangan Anak Penderita Penyakit Ginjal Kronik. Dentika: Dental Journal. 2016;19(1):78-82.https://doi.org/10.32734/dentika.v19i1.157. DOI: https://doi.org/10.32734/dentika.v19i1.157

National Kidney Foundation. KDOQI Clinical Practice guideline for nutrition in children with CKD: 2008 update. American Journal of Kidney Diseases. 2009;53(3).https://doi.org/10.1053/j.ajkd.2008.11.017. DOI: https://doi.org/10.1053/j.ajkd.2008.11.017

Kidney Disease Improving Global Outcomes (KDIGO). Summary of recommendation statements. Kidney Int Suppl. 2013;3(1):5-14.https://doi.org/10.1038/kisup.2012.77. DOI: https://doi.org/10.1038/kisup.2012.77

Published

2024-02-29

How to Cite

1.
Bone Mineral Disorders in Children with Predialysis Chronic Kidney Disease Correlates with Short Stature. Arch Pediatr Gastr Hepatol Nutr [Internet]. 2024 Feb. 29 [cited 2024 Apr. 23];3(1):12-23. Available from: https://apghn.com/index.php/journal/article/view/61