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 |
|---|---|
| Pages (from-to) | 173-177 |
| Number of pages | 5 |
| Journal | Pediatric Nephrology |
| Volume | 7 |
| Issue number | 2 |
| DOIs | |
| State | Published - Apr 1 1993 |
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Keywords
- Feeding
- Growth
- Nutrition
- Uremic infants
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Nephrology
Cite this
Growth of uremic infants on forced feeding regimens. / Abitbol, Carolyn; Zilleruelo, Gaston E; Montane, Brenda; Strauss, Jose.
In: Pediatric Nephrology, Vol. 7, No. 2, 01.04.1993, p. 173-177.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Growth of uremic infants on forced feeding regimens
AU - Abitbol, Carolyn
AU - Zilleruelo, Gaston E
AU - Montane, Brenda
AU - Strauss, Jose
PY - 1993/4/1
Y1 - 1993/4/1
N2 - 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.
AB - 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.
KW - Feeding
KW - Growth
KW - Nutrition
KW - Uremic infants
UR - http://www.scopus.com/inward/record.url?scp=0027497941&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027497941&partnerID=8YFLogxK
U2 - 10.1007/BF00864388
DO - 10.1007/BF00864388
M3 - Article
VL - 7
SP - 173
EP - 177
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 2
ER -