Anthropometric Measures in Children with Renal Failure

  • Andreas Nydegger
  • Julie E. Bines


Anthropometric and body composition assessments provide important information about the nutritional status of dialysis patients. A nutritional assessment by a trained dietitian is therefore recommended for patients diagnosed with renal disease because they are frequently in poor nutritional health. Knowledge of the nutritional health of patients with renal disease is necessary to prescribe and monitor appropriate clinical and nutrition therapies. Anthropometrical methods occupy a meaningful role in assessing the nutritional status of patients with renal disease, are cost-effective screening techniques for describing body size, and they are well suited for identifying levels of body composition, nutritional status or risk for disease. However, children with renal disease present special problems for anthropometry, including decreased functional status and increased comorbidity, which challenge nutrition assessment methodology. Measures of weight, stature, calf circumference, arm circumference and triceps and subscapular skinfolds have therefore been reported for dialysis patients, who tend to be shorter, lighter and have less adipose tissue than healthy persons of the same age. Other techniques to assess body composition are dual energy X-ray absorptiometry (DEXA), bioelectrical impedance, total body water (TBW) and prediction equations. However, irrespective of the technique to be used, all are validated in healthy individuals based on the assumption that body composition parameters are relatively static, which isn’t the case in renal patients. Anthropometric measurements should be an integral component of the routine care of the child and adolescent with renal disease.


Renal Disease Body Composition Anthropometric Measurement Growth Velocity Hydration Status 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Chronic renal failure


End stage renal disease


Body mass index


Dual energy x-ray absorptiometry


Total body water


Fat free mass


Bioelectrical impedendance


Growth hormone


Insulin-like growth factor-1


Total body potassium


  1. Chumlea WC. Anthropometric and body composition assessment in dialysis patients. Semin Dial. 2004;17:466–70.PubMedCrossRefGoogle Scholar
  2. Chumlea WC, Guo SS, Zeller CM, Reo NV, Siervogel RM. Total body water data for white adults 18 to 64 years of age: the Fels Longitudinal Study. Kidney Int. 1999;56:244–52.PubMedCrossRefGoogle Scholar
  3. Cole TJ, Freeman JV, Preece MA. Body mass index reference curves for the UK, 1990. Arch Dis Child. 1995;73:25–9.PubMedCrossRefGoogle Scholar
  4. Davies PS. Body composition assessment. Arch Dis Child. 1993;69:337–8.PubMedCrossRefGoogle Scholar
  5. Fine RN. Growth post renal-transplantation in children: lessons from the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Pediatr Transplant. 1997;1:85–9.PubMedCrossRefGoogle Scholar
  6. Guyer B, Macdorman MF, Martin JA, Peters KD, Strobino DM. Annual summary of vital statistics-1997. Pediatrics. 1998;102:1333–49.PubMedCrossRefGoogle Scholar
  7. Haffner D, Schaefer F, Nissel R, Wuhl E, Tonshoff B, Mehls O. Effect of growth hormone treatment on the adult height of children with chronic renal failure. German Study Group for Growth Hormone Treatment in Chronic Renal Failure. N Engl J Med. 2000;343:923–30.PubMedCrossRefGoogle Scholar
  8. Hokken-Koelega AC, Stijnen T, De Muinck Keizer-Schrama SM, Blum WF, Drop SL. Levels of growth hormone, insulin-like growth factor-I (IGF-I) and -II, IGF-binding protein-1 and -3, and cortisol in prednisone-treated children with growth retardation after renal transplantation. J Clin Endocrinol Metab. 1993;77:932–8.PubMedCrossRefGoogle Scholar
  9. Kuizon BD, Nelson PA, Salusky IB. Tube feeding in children with end-stage renal disease. Miner Electrolyte Metab. 1997;23:306–10.PubMedCrossRefGoogle Scholar
  10. Lohman TG. Applicability of body composition techniques and constants for children and youths. Exerc Sport Sci Rev. 1986;14:325–57.PubMedCrossRefGoogle Scholar
  11. Lohman TG, Roche AF, Martorell R. Anthropometric standardisation reference manual, Illinois, Human Kinetics Books; 1988.Google Scholar
  12. Maxwell H, Rees L. Randomised controlled trial of recombinant human growth hormone in prepubertal and pubertal renal transplant recipients. British Association for Pediatric Nephrology. Arch Dis Child. 1998;79:481–7.PubMedCrossRefGoogle Scholar
  13. Mushtaq T, Ahmed SF. The impact of corticosteroids on growth and bone health. Arch Dis Child. 2002;87:93–6.PubMedCrossRefGoogle Scholar
  14. NHANES-III. Third National Health and Nutrition Examination Survey (NHANES III). In US Department of Health and Human Services, N. C. F. H. S. (ed.). Springfield, VA: National Technical Information Service; 1996.Google Scholar
  15. Norman LJ, Coleman JE, Macdonald IA, Tomsett AM, Watson AR. Nutrition and growth in relation to severity of renal disease in children. Pediatr Nephrol. 2000;15:259–65.PubMedCrossRefGoogle Scholar
  16. Nydegger A, Strauss BJ, Heine RG, Asmaningsih N, Jones CL, Bines JE. Body composition of children with chronic and end-stage renal failure. J Paediatr Child Health. 2007;43:740–5.PubMedCrossRefGoogle Scholar
  17. Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O, Schaefer F. Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation. 2002;106:100–5.PubMedCrossRefGoogle Scholar
  18. Qayyum N, Alcocer L, Maxwell H, Beattie TJ, Murphy AV, Ramage IJ, Ahmed SF. Skeletal disproportion in children with chronic renal disease. Horm Res. 2003;60:221–6.PubMedCrossRefGoogle Scholar
  19. Rashid R, Neill E, Smith W, King D, Beattie TJ, Murphy A, Ramage IJ, Maxwell H, Ahmed SF. Body composition and nutritional intake in children with chronic kidney disease. Pediatr Nephrol. 2006;21:1730–8.PubMedCrossRefGoogle Scholar
  20. Rigden SP, Start KM, Rees L. Nutritional management of infants and toddlers with chronic renal failure. Nutr Health. 1987;5:163–74.PubMedCrossRefGoogle Scholar
  21. Schaefer F, Mehls O, editors. Growth failure in chronic renal disorders. London: Chapman & Hall; 1998.Google Scholar
  22. Schaefer F, Wuhl E, Feneberg R, Mehls O, Scharer K. Assessment of body composition in children with chronic renal failure. Pediatr Nephrol. 2000;14:673–8.PubMedCrossRefGoogle Scholar
  23. Wells JC. A critique of the expression of paediatric body composition data. Arch Dis Child. 2001;85:67–72.PubMedCrossRefGoogle Scholar
  24. Wong CS, Gipson DS, Gillen DL, Emerson S, Koepsell T, Sherrard DJ, Watkins SL, Stehman-Breen C. Anthropometric measures and risk of death in children with end-stage renal disease. Am J Kidney Dis. 2000;36:811–9.PubMedCrossRefGoogle Scholar
  25. Zivicnjak M, Franke D, Ehrich JH, Filler G. Does growth hormone therapy harmonize distorted morphology and body composition in chronic renal failure? Pediatr Nephrol. 2000;15:229–35.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Gastroenterology and Clinical NutritionRoyal Children’s HospitalParkvilleAustralia
  2. 2.Department of PaediatricsUniversity of MelbourneParkvilleAustralia
  3. 3.Murdoch Childrens Research InstituteParkvilleAustralia

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