Perceived appetite and clinical outcomes in children with chronic kidney disease

Frank W. Ayestaran, Michael F. Schneider, Frederick J. Kaskel, Poyyapakkam R. Srivaths, Patricia W. Seo-Mayer, Marva Moxey-Mims, Susan L. Furth, Bradley A. Warady, Larry A. Greenbaum

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

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 m2 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.

Original languageEnglish (US)
Pages (from-to)1121-1127
Number of pages7
JournalPediatric Nephrology
Volume31
Issue number7
DOIs
StatePublished - Jul 1 2016

Keywords

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

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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