Malnutrition and its association with inflammation and vascular disease in children on maintenance dialysis

Background Malnutrition is associated with both inflammation and atherosclerotic cardiovascular disease in adults with chronic kidney disease. We studied the prevalence of malnutrition and its possible associations with inflammation and vascular disease in children on chronic dialysis. Methods Thirty-three patients on maintenance dialysis (18 peritoneal dialysis, 15 hemodialysis) and 19 age--and gender-matched healthy controls were studied. Nutritional status was assessed by anthropometric measurements including body mass index (BMI), upper arm measurements, multifrequency bioimpedance analysis (BIA) and serum levels of albumin, prealbumin, and cholesterol. Inflammation was assessed by serum levels of C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-alpha. The carotid artery intima thickness (cIMT) was measured to assess vascular disease. Results Compared with healthy children, patients had lower anthropometric measurements (P Conclusions Children on dialysis are at an increased risk of malnutrition, inflammation, and vascular disease. Although each of these three conditions exists, there is no interaction among them all. We postulate that the malnutrition-inflammation-atherosclerosis (MIA) complex might not exist in pediatric dialysis patients. Keywords Atherosclerosis * Chronic kidney disease * Children * Dialysis * Malnutrition * Inflammation * MIA complex
Introduction Malnutrition is common among patients with chronic kidney disease (CKD), particularly patients with end-stage kidney disease (ESKD). Its reported prevalence in children with CKD varies between 5 and 80 [...]