Inflammation and nutrition in children with chronic kidney disease

doi:10.5527/wjn.v5.i3.274

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World Journal of Nephrology

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2220-6124

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World J Nephrol. May 6, 2016; 5(3): 274-282
Published online May 6, 2016. doi: 10.5527/wjn.v5.i3.274

Inflammation and nutrition in children with chronic kidney disease

Juan Tu, Wai W Cheung, Robert H Mak

Wai W Cheung, Robert H Mak, Department of Pediatrics, University of California, San Diego, CA 92093-0630, United States

Wai W Cheung, Robert H Mak, Rady Children’s Hospital, San Diego, CA 92123, United States

Juan Tu, Division of Nephrology, Affiliated Hospital of Capital Institute of Pediatrics, Beijing 100020, China

Author contributions: Tu J reviewed the literature and wrote the draft; all authors edited and commented on the final draft of the manuscript.

Supported by The Capital Health Research and Development of Special Research Fund 2014-4-2102 (to Juan Tu).

Conflict-of-interest statement: The authors declare no conflict of interest.

Correspondence to: Robert H Mak, MD, PhD, Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, MC 0630, La Jolla, CA 92093-0630, United States. romak@ucsd.edu

Telephone: +1-858-8226717 Fax: +1-858-8226776

Received: July 29, 2015
Peer-review started: July 31, 2015
First decision: August 14, 2015
Revised: February 2, 2016
Accepted: March 7, 2016
Article in press: March 9, 2016
Published online: May 6, 2016
Processing time: 271 Days and 16.2 Hours

Abstract

Chronic inflammation and nutritional imbalance are important comorbid conditions that correlate with poor clinical outcomes in children with chronic kidney disease (CKD). Nutritional disorders such as cachexia/protein energy wasting, obesity and growth retardation negatively impact the quality of life and disease progression in children with CKD. Inadequate nutrition has been associated with growth disturbances in children with CKD. On the other hand, over-nutrition and obesity are associated with poor outcomes in children with CKD. The exact mechanisms leading to these unfavorable conditions are not fully elucidated and are most likely multifactorial. In this review, we focus on the pathophysiology of nutrition disorders and inflammation and their impact on clinical outcomes in children with CKD.

Keywords: Nutrition; Inflammation; Chronic kidney disease; Protein energy wasting; Cachexia; Obesity; Growth failure; Maternal nutrition

Core tip: Nutritional imbalances, such as protein energy wasting, cachexia, obesity and growth retardation, have been associated with poor clinical outcomes in children with chronic kidney disease (CKD). Chronic inflammation may lead to further deterioration of nutritional imbalance in advanced CKD patients. Results of recent studies have increased awareness of the importance of chronic inflammation and nutritional imbalance in children with CKD.