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Perceived appetite and clinical outcomes in children with chronic kidney disease

  • Ayestaran, Frank W.1, 2
  • Schneider, Michael F.3
  • Kaskel, Frederick J.4
  • Srivaths, Poyyapakkam R.5
  • Seo-Mayer, Patricia W.6
  • Moxey-Mims, Marva7
  • Furth, Susan L.8, 9
  • Warady, Bradley A.10
  • Greenbaum, Larry A.2
  • 1 Emory University, Division of Pediatric Nephrology, 2015 Uppergate Drive, NE, Atlanta, GA, 30322, USA , Atlanta (United States)
  • 2 Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, USA , Atlanta (United States)
  • 3 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA , Baltimore (United States)
  • 4 Albert Einstein School of Medicine, New York, NY, USA , New York (United States)
  • 5 Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA , Houston (United States)
  • 6 Pediatric Specialists of Virginia and Georgetown University Hospital, Fairfax, VA, USA , Fairfax (United States)
  • 7 National Institutes of Health, National Institute of Diabetes and Digestive Kidney Diseases, Bethesda, MD, USA , Bethesda (United States)
  • 8 Children’s Hospital Pennsylvania, Philadelphia, PA, USA , Philadelphia (United States)
  • 9 Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA , Philadelphia (United States)
  • 10 Children’s Mercy Hospital, Kansas City, MO, USA , Kansas City (United States)
Published Article
Pediatric Nephrology
Publication Date
Feb 08, 2016
DOI: 10.1007/s00467-016-3321-9
Springer Nature


BackgroundChildren with chronic kidney disease (CKD) may have impaired caloric intake through a variety of mechanisms, with decreased appetite as a putative contributor. In adult CKD, decreased appetite has been associated with poor clinical outcomes. There is limited information about this relationship in pediatric CKD.MethodsA total of 879 participants of the Chronic Kidney Disease in Children (CKiD) study were studied. Self-reported appetite was assessed annually and categorized as very good, good, fair, or poor/very poor. The relationship between appetite and iohexol or estimated glomerular filtration rate (ieGFR), annual changes in anthropometrics z-scores, hospitalizations, emergency room visits, and quality of life were assessed.ResultsAn ieGFR < 30 ml/min per 1.73 m2 was associated with a 4.46 greater odds (95 % confidence interval: 2.80, 7.09) of having a worse appetite than those with ieGFR >90. Appetite did not predict changes in height, weight, or BMI z-scores. Patients not reporting a very good appetite had more hospitalizations over the next year than those with a very good appetite. Worse appetite was significantly associated with lower parental and patient reported quality of life.ConclusionsSelf-reported appetite in children with CKD worsens with lower ieGFR and is correlated with clinical outcomes, including hospitalizations and quality of life.

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