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Pediatr Nephrol. 2016 Jul;31(7):1121-7. doi: 10.1007/s00467-016-3321-9. Epub 2016 Feb 8.

Perceived appetite and clinical outcomes in children with chronic kidney disease.

Author information

1
Division of Pediatric Nephrology, Emory University, 2015 Uppergate Drive, NE, Atlanta, GA, 30322, USA. frankayestar@health.usf.edu.
2
Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA. frankayestar@health.usf.edu.
3
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
4
Albert Einstein School of Medicine, New York, NY, USA.
5
Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
6
Pediatric Specialists of Virginia and Georgetown University Hospital, Fairfax, VA, USA.
7
National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
8
Children's Hospital Pennsylvania, Philadelphia, PA, USA.
9
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
10
Children's Mercy Hospital, Kansas City, MO, USA.
11
Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA.

Abstract

BACKGROUND:

Children with chronic kidney disease (CKD) may have impaired caloric intake through a variety of mechanisms, with decreased appetite as a putative contributor. In adult CKD, decreased appetite has been associated with poor clinical outcomes. There is limited information about this relationship in pediatric CKD.

METHODS:

A total of 879 participants of the Chronic Kidney Disease in Children (CKiD) study were studied. Self-reported appetite was assessed annually and categorized as very good, good, fair, or poor/very poor. The relationship between appetite and iohexol or estimated glomerular filtration rate (ieGFR), annual changes in anthropometrics z-scores, hospitalizations, emergency room visits, and quality of life were assessed.

RESULTS:

An ieGFR < 30 ml/min per 1.73 m(2) was associated with a 4.46 greater odds (95 % confidence interval: 2.80, 7.09) of having a worse appetite than those with ieGFR >90. Appetite did not predict changes in height, weight, or BMI z-scores. Patients not reporting a very good appetite had more hospitalizations over the next year than those with a very good appetite. Worse appetite was significantly associated with lower parental and patient reported quality of life.

CONCLUSIONS:

Self-reported appetite in children with CKD worsens with lower ieGFR and is correlated with clinical outcomes, including hospitalizations and quality of life.

KEYWORDS:

ER visits; Hospitalization; Nutrition; Pediatric; Quality of life; Renal function

PMID:
26857711
PMCID:
PMC5627603
DOI:
10.1007/s00467-016-3321-9
[Indexed for MEDLINE]
Free PMC Article

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