TY - JOUR
T1 - Perceived appetite and clinical outcomes in children with chronic kidney disease
AU - Ayestaran, Frank W.
AU - Schneider, Michael F.
AU - Kaskel, Frederick J.
AU - Srivaths, Poyyapakkam R.
AU - Seo-Mayer, Patricia W.
AU - Moxey-Mims, Marva
AU - Furth, Susan L.
AU - Warady, Bradley A.
AU - Greenbaum, Larry A.
N1 - Publisher Copyright:
© 2016, IPNA.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - 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.
AB - 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.
KW - ER visits
KW - Hospitalization
KW - Nutrition
KW - Pediatric
KW - Quality of life
KW - Renal function
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U2 - 10.1007/s00467-016-3321-9
DO - 10.1007/s00467-016-3321-9
M3 - Article
C2 - 26857711
AN - SCOPUS:84957640382
SN - 0931-041X
VL - 31
SP - 1121
EP - 1127
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 7
ER -