Abstract
Infants born with congenital renal insufficiency generally grow poorly during the first years of life and incur a height deficit that is rarely regained. Actual energy and protein requirements have not been determined for these children. In 12 infants with creatinine clearances less than 70 ml/min per 1.73 m2, growth and nutrient intakes were monitored during the first 2 years of life. Forced feeding regimens after 3 months of age, including gastrostomy in 3 patients, were necessary to maintain energy intakes near 100% of the recommended dietary allowance (RDA). Protein intakes averaged in excess of 140% RDA. Linear growth did not correlate with either energy or protein intakes, suggesting that neither was a limiting factor to growth. Length velocity standard deviation score (LV-SDS) did not correlate with degree of renal insufficiency at any age, but average LV-SDS did relate significantly and inversely to C-terminal parathyroid hormone (PTH) levels. Growth parameters, including LV-SDS and weight velocity SDS (WV-SDS) were lowest at 6 months of age. Weight and length SDS followed with a maximum decline at 12 months of age. While weight for length SDS remained normal and WV-SDS showed recovery during the 2nd year, LV-SDS remained negative. Length SDS stabilized near - 2 SDS. In summary, these data suggest that the major height deficit in infants with renal insufficiency is incurred during the first 6 months of life. Ponderal indices suggested that very early nutritional deficits may have been a primary contributor to subsequent height deficits. Despite recovery in ponderal indices and accelerations in linear growth velocity, catch-up growth was not apparent during the 2nd year. Inadequately treated bone disease, as evidenced by elevated PTH, had a negative impact on linear growth, predicating the need for earlier and better management of bone disease in these infants.
Original language | English (US) |
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Pages (from-to) | 173-177 |
Number of pages | 5 |
Journal | Pediatric Nephrology |
Volume | 7 |
Issue number | 2 |
DOIs | |
State | Published - Apr 1 1993 |
Keywords
- Feeding
- Growth
- Nutrition
- Uremic infants
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Nephrology