GROWTH AND NUTRITION IN CHILDREN ON PERITONEAL DIALYSIS

Abstract

Growth retardation and malnutrition are common in children with chronic kidney disease and increase with the degree of kidney faluret to become maximal in children at the dialysis stage, leading to a risk of increasing mortality. Despite many advances in the field of pediatric dialysis, small size in adulthood remains very common in this population. The origin of malnutrition and growth retardation is complex and multifactorial. In infants on peritoneal dialysis, insufficient nutritional intake is recognized as a major barrier to adequate growth. The diagnostic approach to malnutrition and growth retardation in peritoneal dialysis requires the use of several elements: an evaluation of medical history, a clinical examination, and various complementary examinations. Due to the multifactorial aspects of the nutritional and statural status of the pediatic patients, several therapeutic axes have to be taken in account, mainly a nutritional treatment adapted to the needs of the child, a specific treatment by growth hormone, and an optimization of dialysis to allow optimal metabolic control.