Abstract:

Abstracts： Objective To evaluate the nutritional status and the factors related to nutrition in children with chronic kidney disease（CKD）. To explore the biological monitoring index of nutritional status of children with CKD. Methods Totally 123 patients with CKD hospitalized in our hospital from 2009 to the end of 2011 were enrolled in this study. Another 168 healthy children were chosen as control group. The height，weight，and insulin-like growth factor binding proteins 3 （IGFBP3） of the two groups were measured. The median percentage of weight for age（W/A），height for age （H/A）and weight for height （W/H）， BMI and glomerular filtration rate （GFR） were also calculated. The nutritional status was assessed according to the methods recommended by American Academy of Pediatrics. The relationship between the nutritional status and GFR， gender as well as the duration of CKD were analyzed. Nutritional knowledge questionnaire for parents of children in CKD group was taken. Results The levels of W/A in 70（56.91%）， H/A in 63（51.22%） and W/H in 60 （48.78%） children with CKD were lower than that of the control group（χ2=78.676，41.853，39.281， P=0.000）， and were positively correlated with the glomerular filtration rate （r=0.552，0.368，0.539； P=0.000）. The serum levels of IGFBP3 were much higher than the control’s（t=2.725， P=0.008）. The number of overweight and obesity was 21 cases （17.07%）. About 76.67% parents of children with CKD had no knowledge of nutrition. Conclusion Malnutrition is the common complication in CKD children.The nutritional status in CKD children is positively related to the glomerular filtration rate. Serum IGFBP3 and GFR can be the biological monitoring index of nutritional status. Obesity in CKD children can’t be ignored.It is important to guide and popularize knowledge of nutrition periodically.

摘要：

目的 了解慢性肾脏病（CKD）患儿营养状况及其影响因素，探讨能够预测营养状况的相关指标。方法 选取2009—2011年就诊于首都医科大学附属北京儿童医院肾脏内科的CKD患儿123例为CKD组， 正常儿童168名为正常对照组。测量两组身高（H）、 体重（W）、 肌酐、 胰岛素样生长因子结合蛋白3（IGFBP3）， 计算年龄标准体重（W/A）、 年龄标准身高（H/A）、 身高标准体重（W/H）、 体重指数（BMI）及肾小球滤过率（GFR）。对30例CKD组家长进行营养知识问卷调查。评价 CKD 儿童营养状况， 分析 GFR、 性别、 病程等因素与营养状况的相关性。 结果 CKD组W/A 70例（56.91%）降低，H/A 63例（51.22%）降低，W/H 60例（48.78%）降低，其发生率高于正常对照组（16.07%、18.45%、23、81%，P＜0.05），与GFR呈显著正相关（r=0.552、0.368、0.539，P＜0.05）；CKD组血IGFBP3高于正常对照组，差异有统计学意义（t=2.725，P＜0.05）。超重和肥胖21例（17.07%）。76.67%（23/30） CKD患儿父母不了解营养知识。结论 营养不良是CKD儿童常见并发症，营养状况与肾功能相关。血IGFBP3与GFR可以作为CKD儿童营养状况的高危指标。定期营养指导、普及营养知识很重要。

关键词: 慢性肾脏病, 儿童, 营养, 肾小球滤过率