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A desnutrição está freqüentemente relacionada com doenças crônicas. O diagnóstico precoce realizado por técnicas práticas e simples favorece o tratamento, minimizando as complicações. OBJETIVO: avaliar a situação nutricional de crianças e adolescentes com insuficiência renal crônica (IRC) utilizando parâmetros antropométricos. MÉTODOS: Foram avaliadas 41 crianças e adolescentes com IRC ("clearance" de creatinina abaixo de 50 ml/min/1,73m2) acompanhadas no Ambulatório de Nefrologia Pediátrica do HC-Unicamp, de janeiro de 1995 a novembro de 1996, pelas medidas do perímetro braquial (PB) e da prega cutânea tricipital (PCT), com as quais calculou-se a área de gordura braquial (AGB) e área muscular braquial (AMB) e os respectivos escores z. Estas medidas foram realizadas pelo menos duas vezes, com intervalo de 0,21 a 1,3 anos (0,88 ± 0,04). RESULTADOS: Os escores z obtidos tanto para PB, como para PCT, AGB e AMB apresentaram valores muito baixos, sendo que, na evolução, apenas o escore z de AMB apresentou melhora estatisticamente significativa (p= 0,03 teste de Wilcoxon). Quando selecionados quanto ao tratamento de substituição renal, apenas os transplantados renais apresentaram melhora estatisticamente significativa para o escore z de PB (p= 0,02 teste de Wilcoxon). CONCLUSÃO: Estes dados mostram uma situação nutricional comprometida tanto em relação à reserva de gordura, quanto de músculo, com melhora no acompanhamento apenas em relação à área muscular.BACKGROUND: the purpose of this study is to evaluate the nutritional status of children and teenagers with chronic renal (CRF) failure using anthropometric measurements. MATERIAL AND METHODS: 41 children and adolescents with (CRF) (creatinine "clearance" < 50 ml/min/1,73m2) followed at the Pediatric Nephrology Unit (HC-UNICAMP), between January 1995 and November 1996, were evaluated by the assessment of anthropometric measurements, mid upper arm circunference (MUAC) and triceps skinfold (TSF). With these measurements, mid arm fat area (MUAFA) and arm muscle area (AMA) were calculated and its z-scores. These measurements were performed twice at least, ranging from 0.21 to 1.3 years (0.88 ± 0.04). RESULTS: all the z-scores (MUAC, TSF, MUAFA and AMA) were very low, and only the AMA z-score was statistically significant (p= 0,03 Wilcoxon test). The patients were divided in to groups, according to their treatment, and the MAC z-score for the renal transplantation group was statistically significant (p= 0,02 Wilcoxon test). CONCLUSIONS: these data demonstrate a compromised nutritional status from both muscle and fat stores, with an improvement in muscle stores.

Background Mood and anxiety disorders are frequently observed in systemic lupus erythematosus (SLE) patients, and there are, probably due to physical disability and stress of living with chronic disease. However, these symptoms have not been evaluatedover time in childhood-onset SLE (cSLE) so far. Objectives To investigated mood and anxiety disorders pattern over time in cSLE. To explore potential relationships between mood and anxiety and clinical/laboratorial manifestations and treatment. Methods Consecutive cSLE patients recruited from the Pediatric Rheumatology Outpatient Clinic of State University of Campinas were included in this study. We followed up 51 cSLEpatients for two years (baseline (T0), 6 (T1), 12 (T2) and 18 months (T3). Three patients in use of antidepressants were excluded.Clinical visits were scheduled semiannuallywithinterval visits scheduled when necessary due to diseaseactivity or complications. Mood and anxiety disorderswere determined through Becks Depression and Becks Anxiety Inventory in all participants. For patients under sixteen years old, Children9s Depression Inventory (CDI) was applied.These scales consist of 21 items, each describing a common symptom of depression/anxiety. The respondent is asked to rate how much he or she has been bothered by each symptom over the past month on a 4-point scale ranging from 0 to 3. The items are summed to obtain a total score that can range from 0 to 63. The cutoffs used for the BDI are: 0–13: no/minimal depression; 14–19: mild depression; 20–28: moderate depression; and 29–63: severe depression and for the BAI: 0-7: no/minimal level of anxiety; 8-15: mild anxiety; 16-25: moderate anxiety; 26-63: severe anxiety. The cutoff used for CDI is 17. SLE patients were further assessed for clinical and laboratory SLE manifestations, disease activity [SLE Disease Activity Index (SLEDAI)], damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] and current drug exposures. We used Mann-Whitney Test to compare the scores of BAI and BDI between the groups and to longitudinal analyses, we used Friedman Test. Results We included 51cSLE patients (46 girls) with mean age of mean age of 16.15 [Standard deviation (SD) ±3.03 years; range 10-23]. Disease duration was 3.66 (SD ±3.0; range 1-12 years).We observed a significant variation in anxiety scores (p=0.04) and depression scores (p=0.02) over time. Cumulative damage was associated with a worsening of anxiety (p=0.01). No association between mood and anxiety disorders and disease activity (p>0.05) and corticosteroid dose (p>0.05) was observed. In addition, no difference in mood disorders in patients with and without immunosuppressant medication was observed. Conclusions Mood and anxiety disorders have a significant variation over time in cSLEpatients. Cumulative damage is associated with worsening of anxiety incSLE patients. Acknowledgements Grants: Research Support Foundation of Sao Paulo –FAPESP (Simone 2008/02917-0, Mariana 2011/03788-2, Aline 2013/09480-5, Nailu 2010/13637-9) CNPQ (300447/2009-4 and 471343/2011-0; 302205/2012-8; 473328/2013-5) Disclosure of Interest None declared