Growth of uremic infants on forced feeding regimens

Carolyn Abitbol, Gaston E Zilleruelo, Brenda Montane, Jose Strauss

Research output: Contribution to journalArticle

50 Citations (Scopus)

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 languageEnglish
Pages (from-to)173-177
Number of pages5
JournalPediatric Nephrology
Volume7
Issue number2
DOIs
StatePublished - Apr 1 1993

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Weights and Measures
Growth
Renal Insufficiency
Recommended Dietary Allowances
Bone Diseases
Parathyroid Hormone
Proteins
Gastrostomy
Energy Intake
Creatinine
Intercellular Signaling Peptides and Proteins
Food

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 journalArticle

Abitbol, C, Zilleruelo, GE, Montane, B & Strauss, J 1993, 'Growth of uremic infants on forced feeding regimens', Pediatric Nephrology, vol. 7, no. 2, pp. 173-177. https://doi.org/10.1007/BF00864388
Abitbol, Carolyn ; Zilleruelo, Gaston E ; Montane, Brenda ; Strauss, Jose. / Growth of uremic infants on forced feeding regimens. In: Pediatric Nephrology. 1993 ; Vol. 7, No. 2. pp. 173-177.
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