RESUMO
OBJECTIVE: Nutrition and growth are important outcome indicators in pediatric (Ped) hemodialysis (HD) patients. We hypothesized that there is a discrepancy among traditional measures of nutrition, and that adequate nutrition may not reliably predict growth. METHODS: We assessed longitudinal nutrition and growth parameters in 14 Ped HD patients over 1 year. Their age at the end of the study was 15.9 +/- 0.6 years, SEM. RESULTS: For the entire cohort over 1 year, serum albumin (Alb) was 4.3 +/- 0.0 g/dL, and the normalized protein catabolic rate (nPCR) was 1.0 +/- 0.0 (correlation, 0.33; P < .0001). The relationship between Alb and nPCR was significant in only 4/14 (29%). The mean standard deviation and variance were higher for Alb (0.27 +/- 0.03) compared with nPCR (0.18 +/- 0.02). The body mass index percentile (BMI%) was 35.5 +/- 2.9, the percent ideal body weight (%IBW) was 96.2 +/- 1.5, the height-SDS, or standard deviation score (Ht-SDS) was -1.30 +/- 0.11, and the percent weight change (PWC) was +4.9% +/- 1.9%. The highest incidence of reaching our targets for growth was seen for the BMI% (64% of patients) and PWC (79% of patients). The target for Ht-SDS was attained in only 21%. There was a significant negative relationship between Alb and nPCR with BMI%, %IBW, and Ht-SDS, and a significant positive relationship between Alb and nPCR with PWC. CONCLUSION: We conclude that the relationship between Alb and nPCR is weak in individual patients, and that adequate nutrition does not reliably predict growth in Ped HD patients.
