Assessment tool helps track malnutrition in pediatric patients with ESKD
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Key takeaways:
- Researchers have designed an assessment tool to detect malnutrition in pediatric patients with end-stage kidney disease.
- Protein-energy wasting is a result of insufficient nutrient intake and catabolism.
SAN DIEGO — Researchers have developed a new tool to assess malnutrition in children with end-stage kidney disease to help prevent protein-energy wasting, according to a presentation here.
“Protein-energy wasting in end-stage kidney disease is a result of insufficient nutrient intake, uremia, inflammation and catabolism,” Dani Jackson MSN, CPNP-PC, of the division of nephrology, hypertension and apheresis in the department of pediatrics at the Children’s Hospital of St. Louis in Washington, and colleagues wrote in a poster at the Annual Dialysis Conference. “For pediatric patients [on dialysis], growth is a sensitive marker of nutritional adequacy,” the authors wrote. They added, “We felt our nutritional assessment was lacking and that there was opportunity to improve this process.”
In developing the tool, Jackson and colleagues identified information already being gathered monthly by dietitians, including albumin, protein catabolic rate, BMI, Gomez classification and age-based expected weight trends. The degree of abnormality and modality choice of the pediatric patients were used as a base to determine point values.
“Weight trends, BMI percentile and the Gomez classification [of the patients]were given possibility for higher value,” the authors wrote. “A higher score corresponds to increased concern for malnutrition for which intervention and more frequent screening would be indicated.” Hemodialysis had a maximum score of 9; peritoneal dialysis had a max score of 8, they reported.
After parameters were set for hemodialysis and peritoneal dialysis, the assessment tool was launched in March 2023 and evaluated through June 2023. The researchers assigned point values, recommended interventions and offered rescreening guidelines.
“Starting in July 2023 we began using this tool regularly following the references and guidelines listed. In the evaluation phase there were 22 assessments across 9 [hemodialysis] patients, and 38 assessments across 16 PD patients,” Jackson and colleagues wrote. “Our initial experience is promising, though further assessment and tracking is indicated to establish appropriate and specific interventions, as well as best re-screening timeframes.
“Evaluation of this tool’s longitudinal accuracy, as well as correlation with improvement in growth parameters, would help strengthen its use,” they wrote.
Reference:
Jackson D. Development of a nutrition assessment tool for pediatric dialysis patients. Presented at: Annual Dialysis Conference, March 8-10, 2024. San Diego.
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Jackson D. Development of a nutrition assessment tool for pediatric dialysis patients. Presented at: Annual Dialysis Conference, March 8-10, 2024. San Diego.
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