Efficacy of intradialytic amino acids on nutritional status in children with stage 5 chronic kidney disease
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ORIGINAL ARTICLE
Efficacy of intradialytic amino acids on nutritional status in children with stage 5 chronic kidney disease Hagar El-Saied Saad El-Serw 1 & Dina Abdel Rasoul Helal Bassiouni 2 & Angy Adel Al-Wakeil 2 & Ragaa Shawky Aly Ibrahim El-Masry 3 & Ashraf Mohamed Abd EI Basset Bakr 2 Received: 8 June 2020 / Revised: 7 September 2020 / Accepted: 30 September 2020 # IPNA 2020
Abstract Background Protein energy wasting (PEW) is a common cause of morbidity and mortality in patients with stage 5 chronic kidney disease (CKD 5). Intradialytic parenteral nutrition (IDPN) has been used as a therapy for preventing and treating PEW in children with CKD 5 when other conventional modalities fail. However, not enough data is available to define its effectiveness in treating malnutrition in children. This study aims to investigate potential benefits of IDPN in Egyptian children with CKD 5. Methods In this prospective, placebo-controlled, parallel-group single blinded study, we enrolled 50 CKD 5 patients; 25 patients (intervention group) received intravenous amino acids (KIDIMN), while 25 patients (control group) received normal saline as placebo, each given during regular dialysis 3 times a week for 9 months. Patients were subjected to nutritional assessment at baseline and 3-, 6-, and 9-month follow-up using height Z-score, hand grip strength (HGS) for muscle power assessment, body composition monitor (BCM) for assessing lean tissue mass (LTM) and adipose tissue mass (ATM), and biochemical measures including serum albumin, serum triglyceride, and serum cholesterol. Results When comparing baseline and 9-month follow-up values, significant improvement was recorded in height Z-score, LTM, and serum albumin in the intervention group unlike the control group where no significant changes were recorded. Conclusion IDPN is proposed to be an effective method for preventing and treating malnutrition in children with CKD 5. However, further multi-centric studies with larger sample size and longer duration of follow-up are still recommended. Keywords Children . Kidney failure . Protein energy wasting . Parenteral nutrition . Amino acids . Dialysis
Introduction * Dina Abdel Rasoul Helal Bassiouni [email protected] Hagar El-Saied Saad El-Serw [email protected] Angy Adel Al-Wakeil [email protected] Ragaa Shawky Aly Ibrahim El-Masry [email protected] Ashraf Mohamed Abd EI Basset Bakr [email protected] 1
Faculty of Medicine, Mansoura University, Mansoura, Egypt
2
Faculty of Medicine, Pediatric Department, Mansoura University, Elgomhoria Street, Mansoura, Egypt
3
Public Health & Preventive Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Protein energy wasting (PEW) in patients with stage 5 chronic kidney disease (CKD 5) represents a diagnostic and therapeutic dilemma [1–3]. PEW is highly prevalent among kidney disease patients, with up to 50% of CKD 5 patients being affected. Moreover, it represents an independent predictor of morbidity and mortality. Many different mechanisms and factor
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