Philippine E-Journals

Nutritional outcomes in pediatric patients with chronic kidney disease on continuous ambulatory peritoneal dialysis and maintenance hemodialysis

Ann Mariel F. Malamug | Phoebe Anne Diño-santos

Discipline: medicine by specialism

 

Abstract:

OBJECTIVE: To compare the nutritional outcomes of pediatric patients with chronic kidney disease on continuous ambulatory peritoneal dialysis and maintenance hemodialysis. MATERIALS AND METHODS: A total of 20 patients on CAPD and 26 patients on hemodialysis were included in the retrospective study. Review of medical charts from January 2023 to 2025 was done. Data from CAPD cohort were taken on the first outpatient consult and on the fourth month on dialysis while data from those on HD were taken on the third month post initiation of hemodialysis and 6th month on hemodialysis. The timing of data collection was designed to coincide with the period of patient adaptation to the dialysis modality, thereby limiting potential confounding variables. Anthropometrics were plotted using the world health organization growth charts for age. Data were statistically treated and a p value of 0.05 was deemed significant. RESULTS: There was no significant difference in the demographic profile of the two cohorts. Chronic glomerulonephritis is the most common primary renal disease in both groups. As to nutritional parameters, there is a statistically significant difference between the weight of the HD and PD cohort (p=0.03) where in the HD group, Weight decreased from baseline of 41.3 to 39.8 (p=0.10) whereas an increasing trend in CAPD group from 39.3 to 40.6 (p=0.18). The same trend is observed in BMI for this group (p=0.05), HD having 18.5 to 18.0 (p=0.20) and CAPD group from 18.0 to 18.5 (p=0.10). no significant difference between the groups in terms of height (p=0.80) No statistical significance in the differences between HD and CAPD cohort in terms of biochemical profile. However, Intragroup comparison revealed a statistically significant increase in serum albumin within the HD group. In terms of prevalence of malnutrition, majority of patients in both cohorts are wasted (61.5%HD 40%CAPD) and stunted (61.5% HD, 40.8%CAPD). CONCLUSION: The mode of dialysis has different nutritional outcomes. CAPD offers a favorable trend of anthropometric measures which can effect better weight maintenance and a lower prevalence of wasting and stunting compared to HD. However, serum albumin, which is a marker for mortality risk and nutritional health has significant improvement in HD group.