Bibliographic Details
| Title: |
Catabolismo proteico en pacientes pediátricos en diálisis peritoneal crónica. |
| Alternate Title: |
Protein catabolism in pediatric patients on chronic peritoneal dialysis. |
| Authors: |
Wong Lam, Carolina1,2 carolinawongl@gmail.com, Fuentes Del Pozo, María Trinidad3, Sandoval Durán, Bárbara3, María del Hevia Juricic, Pilar1 |
| Source: |
Andes Pediatrica. may/jun2026, Vol. 97 Issue 3, p404-413. 10p. |
| Subjects: |
Protein metabolism, Chronic kidney failure, Child patients, Growth of children, Dietary proteins, Proteolysis |
| Abstract (English): |
Energy deficiency and protein catabolism affect the growth of children with chronic kidney disease (CKD). Current protein recommendations are based on the Dietary Reference Intakes (DRI 2005) and nitrogen balance studies in children undergoing chronic peritoneal dialysis (CPD), including nitrogen losses in dialysate fluid, urine, and feces. Objective: To estimate protein requirements in children on CPD by measuring total protein catabolism (tPC) plus growth requirements and comparing them with international recommendations, and analyze the clinical intervention based on individualized protein adjustments according to tPC values to achieve a growth nitrogen balance. Patients and Method: Retrospective and analytical study. We reviewed clinical records of pediatric patients on CPD, treated at a referral hospital in Santiago, Chile, between 2017 and 2024. tPC values plus growth requirements were compared with the Kidney Disease Outcomes Quality Initiative (KDOQI) 2009 guidelines. Key biochemical parameters as treatment targets in this condition and length- or height-for-age Z-score were assessed at baseline and after 12 months of follow-up, adjusted for protein intake. Results: A total of 48 tPC measurements were recorded in 12 patients. The median age at initiation of CPD was 8 years and 2 months. The main etiologies were glomerulopathies and structural anomalies. The calculated protein requirements significantly exceeded the established recommendations, except for the 14-15 year old group, which had a statistically significantly lower value. Biochemical parameters remained stable, and height progressed adequately. Conclusion: Individual estimation of protein requirements based on total protein catabolism was higher than international recommendations. This approach allowed maintenance of growth without metabolic compromise. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): |
La deficiencia energética y el catabolismo proteico afectan el crecimiento de niños/as con enfermedad renal crónica (ERC). Las recomendaciones actuales de proteínas se basan en la Dietary Reference Intakes (RDI 2005) y en estudios de balance nitrogenado en niños con diálisis peritoneal crónica (DPC) considerando pérdidas de nitrógeno en líquido del dializado, urinarias y fecales. Objetivos: Estimar las necesidades proteicas en niños en DPC mediante la medición del catabolismo proteico total (CPt) sumado el requerimiento de crecimiento y compararlos con las recomendaciones internacionales. Analizar la intervención clínica basada en ajustes individualizados de proteínas según el valor de CPt para un balance nitrogenado de crecimiento. Pacientes y Método: Estudio retrospectivo y analítico. Se revisaron registros clínicos de pacientes pediátricos en DPC atendidos en un hospital de referencia en Santiago de Chile entre 2017 y 2024. Los valores CPt sumado el requerimiento de crecimiento se compararon con recomendaciones de las guías Kidney Disease Outcomes Quality Initiative (KDOQI) 2009. El crecimiento con Z score talla para la edad (Z T/E) y parámetros bioquímicos principales como objetivos de tratamientos en esta condición fueron evaluados al ingreso y a los 12 meses de seguimiento ajustado el aporte proteico. Resultados: Se registraron 48 mediciones de CPt en 12 pacientes. La mediana de edad al inicio de DPC fue 8 años 2 meses. Las principales etiologías fueron glomerulopatías y anomalías estructurales. El requerimiento proteico calculado superó con significancia estadística las recomendaciones establecidas, excepto el grupo de 14 a 15 años de edad que resultó un valor con significancia estadística menor. Los parámetros bioquímicos se mantuvieron estables y la talla progresó adecuadamente. Conclusiones: La estimación individual del requerimiento proteico basada en CPt resultó mayor a las recomendaciones internacionales. Este enfoque permitió mantener crecimiento sin compromiso metabólico. [ABSTRACT FROM AUTHOR] |
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| Database: |
MedicLatina |
