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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.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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
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.