Renal function in protein-energy malnutrition

Abstract

So far, most studies on renal function in children with advanced protein-energy malnutrition have shown an impairment of glomerular filtration rate and renal plasma flow, as well as diminished ability to excrete an acid load and a concentrated urine. Investigation of these functions in eight marasmic infants and eight children with kwashiorkor once they were free of obvious infections and acute electrolyte disturbances has shown a practically normal renal performance. Advanced protein-energy malnutrition does not per se cause renal dysfunction, which rather appears to be due to the usual complications of malnutrition. Various abnormalities in kidney function have been described in chronic, severe, protein-energy malnutrition. Those most frequently found are a diminished glomerular filtration rate and renal plasma flow, an impairment of renal concentrating ability, and a decreased capacity to excrete a maximally acid urine after an ammonium chloride load. However, normal values for various functions have been found in malnutrition not complicated by gastrointestinal or respiratory infections. Present results support the latter notion.