Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica

Background: Stunting is common among pediatric patients on peritoneal dialysis. Aim: To stablish the best profile for urea kinetic variables associated to growth in children on chronic peritoneal dialysis (PD). Patients and Methods: Twenty patients, aged 1 month to 14 years, 13 males, were followed...

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Autores principales:	Cano Sch,Francisco, Azócar P,Marta, Marín B,Verónica, Rodríguez S,Eugenio, Delucchi B,Angela, Ratner R,Rinat, Cavada C,Gabriel
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2005
Materias:	Growth and development Kidney failure chronic Pediatrics Dialysis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200007
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spelling	oai:scielo:S0034-988720050012000072006-01-27Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátricaCano Sch,FranciscoAzócar P,MartaMarín B,VerónicaRodríguez S,EugenioDelucchi B,AngelaRatner R,RinatCavada C,Gabriel Growth and development Kidney failure chronic Pediatrics Dialysis Background: Stunting is common among pediatric patients on peritoneal dialysis. Aim: To stablish the best profile for urea kinetic variables associated to growth in children on chronic peritoneal dialysis (PD). Patients and Methods: Twenty patients, aged 1 month to 14 years, 13 males, were followed for 6-12 months, with monthly measurements of weight/age and height/age Z score; plasma creatinine, BUN, protein and albumin and urine and dialysate urea nitrogen, creatinine, protein and albumin. Minimum total Kt/V was 2.1. Dialysis dose (Kt/V), Protein Equivalent of Urea Nitrogen Appearence (PNA), Protein Catabolic Rate (PCR) and Nitrogen Balance (NB) were calculated. To identify the variable(s) associated to growth, the Tree Classification Model (CART) Enterprise Miner 8.1 was applied. Results: Mean total/residual Kt/V: 3.4±1.3/1.69±1.27; Daily Protein Intake (DPI) was 3.25±1.27 g/kg/day. nPNA, PCR and NB were 1.37±0.44, 0.84±0.33 and 1.86±1.25 g/kg/day, respectively. Mean heigth/age Z score was -2.3±1.19. Eleven patients showed a positive height/age delta Z (mean 0.55±0.38) and nine showed a negative growth (mean -0.50±0.42). The main variable explaining the positive growth was a Nitrogen Balance between 0.54 and 2.37 g/kg/day, mean 1.55±0.21 (p <0.001). The second associated variable to growth was a residual Kt/V between 0.43 and 4.6 (2.02±0.49) (p <0.05). Kt/V and nPNA showed a significant correlation, but no correlation could be found between Kt/V and NB. Conclusions: Nitrogen Balance was the main variable associated to growth in pediatric PD, with values between 0.53 to 2.38 g/kg/day. The second variable was a residual Kt/V between 0.43 and 4.6. Therapy should be reassessed with NB values less than 0.54 or above 2.37 g/kg/day (Rev Méd Chile 2005; 133: 1455-65)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.12 20052005-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200007es10.4067/S0034-98872005001200007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Growth and development Kidney failure chronic Pediatrics Dialysis
spellingShingle	Growth and development Kidney failure chronic Pediatrics Dialysis Cano Sch,Francisco Azócar P,Marta Marín B,Verónica Rodríguez S,Eugenio Delucchi B,Angela Ratner R,Rinat Cavada C,Gabriel Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica
description	Background: Stunting is common among pediatric patients on peritoneal dialysis. Aim: To stablish the best profile for urea kinetic variables associated to growth in children on chronic peritoneal dialysis (PD). Patients and Methods: Twenty patients, aged 1 month to 14 years, 13 males, were followed for 6-12 months, with monthly measurements of weight/age and height/age Z score; plasma creatinine, BUN, protein and albumin and urine and dialysate urea nitrogen, creatinine, protein and albumin. Minimum total Kt/V was 2.1. Dialysis dose (Kt/V), Protein Equivalent of Urea Nitrogen Appearence (PNA), Protein Catabolic Rate (PCR) and Nitrogen Balance (NB) were calculated. To identify the variable(s) associated to growth, the Tree Classification Model (CART) Enterprise Miner 8.1 was applied. Results: Mean total/residual Kt/V: 3.4±1.3/1.69±1.27; Daily Protein Intake (DPI) was 3.25±1.27 g/kg/day. nPNA, PCR and NB were 1.37±0.44, 0.84±0.33 and 1.86±1.25 g/kg/day, respectively. Mean heigth/age Z score was -2.3±1.19. Eleven patients showed a positive height/age delta Z (mean 0.55±0.38) and nine showed a negative growth (mean -0.50±0.42). The main variable explaining the positive growth was a Nitrogen Balance between 0.54 and 2.37 g/kg/day, mean 1.55±0.21 (p <0.001). The second associated variable to growth was a residual Kt/V between 0.43 and 4.6 (2.02±0.49) (p <0.05). Kt/V and nPNA showed a significant correlation, but no correlation could be found between Kt/V and NB. Conclusions: Nitrogen Balance was the main variable associated to growth in pediatric PD, with values between 0.53 to 2.38 g/kg/day. The second variable was a residual Kt/V between 0.43 and 4.6. Therapy should be reassessed with NB values less than 0.54 or above 2.37 g/kg/day (Rev Méd Chile 2005; 133: 1455-65)
author	Cano Sch,Francisco Azócar P,Marta Marín B,Verónica Rodríguez S,Eugenio Delucchi B,Angela Ratner R,Rinat Cavada C,Gabriel
author_facet	Cano Sch,Francisco Azócar P,Marta Marín B,Verónica Rodríguez S,Eugenio Delucchi B,Angela Ratner R,Rinat Cavada C,Gabriel
author_sort	Cano Sch,Francisco
title	Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica
title_short	Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica
title_full	Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica
title_fullStr	Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica
title_full_unstemmed	Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica
title_sort	dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica
publisher	Sociedad Médica de Santiago
publishDate	2005
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200007
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Dosis de diálisis, nutrición y crecimiento en diálisis peritoneal pediátrica

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