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Efficacy of intradialytic amino acids on nutritional status in children with stage 5 chronic kidney disease

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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.

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Authors and Affiliations

  1. Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Hagar El-Saied Saad El-Serw

  2. Faculty of Medicine, Pediatric Department, Mansoura University, Elgomhoria Street, Mansoura, Egypt

    Dina Abdel Rasoul Helal Bassiouni, Angy Adel Al-Wakeil & Ashraf Mohamed Abd EI Basset Bakr

  3. Public Health & Preventive Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Ragaa Shawky Aly Ibrahim El-Masry

Authors
  1. Hagar El-Saied Saad El-Serw
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  2. Dina Abdel Rasoul Helal Bassiouni
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  3. Angy Adel Al-Wakeil
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  5. Ashraf Mohamed Abd EI Basset Bakr
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Corresponding author

Correspondence to Dina Abdel Rasoul Helal Bassiouni.

Ethics declarations

The study protocol was submitted to the institution research board of the Faculty of Medicine, Mansoura University, for approval. The protocol was granted approval in December 2016, IRB Code number: MS/16.07.46. Written consent was taken from parents, and patients in the adolescent age group additionally gave consent.

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The authors declare that they have no conflict of interest.

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El-Serw, H.ES.S., Bassiouni, D.A.R.H., Al-Wakeil, A.A. et al. Efficacy of intradialytic amino acids on nutritional status in children with stage 5 chronic kidney disease. Pediatr Nephrol 36, 1561–1569 (2021). https://doi.org/10.1007/s00467-020-04806-x

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  • DOI: https://doi.org/10.1007/s00467-020-04806-x

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