nPCR assessment and IDPN treatment of malnutrition in pediatric hemodialysis patients

Pediatr Nephrol. 2002 Jul;17(7):531-4. doi: 10.1007/s00467-002-0925-z. Epub 2002 Jun 21.


Very few pediatric studies have monitored nutritional status using normalized protein catabolic rate (nPCR) or treating protein-energy malnutrition (PEM) with intradialytic parenteral nutrition (IDPN). The current study compares nPCR with serum albumin as a marker for nutritional status and examines the effectiveness of IDPN treatment in three malnourished adolescent patients receiving chronic hemodialysis in a pediatric dialysis unit. All patients demonstrated reversal of weight loss and initiation of weight gain within 6 weeks of IDPN initiation. Mean values of monthly percentage weight and percentage body mass index (BMI) change were significantly lower in the pre-IDPN era (-0.61+/-2.70 and -1.3+/-2.7) versus the IDPN treatment period (1.8+/-2.1 and 1.3+/-2.1) ( P<0.02). Two patients attained ideal body weight and IDPN was discontinued after 5 months. Patients required 150% recommended daily allowance to achieve weight and BMI gain. While mean monthly nPCR was significantly lower in the pre-IDPN period versus the IDPN period (1.05+/-0.36 versus 1.35+/-0.37, P<0.05), monthly serum albumin levels were no different before and after IDPN was initiated (3.7+/-0.8 versus 3.8+/-0.6). The current study demonstrates IDPN to be effective therapy for adolescent hemodialysis patients with PEM not correctable by enteral supplementation. nPCR was superior to serum albumin as a nutritional status marker in these malnourished pediatric patients receiving hemodialysis.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adolescent Nutritional Physiological Phenomena
  • Adult
  • Body Weight
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Parenteral Nutrition / methods*
  • Protein-Energy Malnutrition / diagnosis
  • Protein-Energy Malnutrition / etiology
  • Protein-Energy Malnutrition / therapy*
  • Proteins / metabolism
  • Renal Dialysis / methods*
  • Sensitivity and Specificity
  • Serum Albumin / metabolism


  • Proteins
  • Serum Albumin