Department of Pediatric Nephrology, Dialysis, and Transplantation, Helen DeVos Children's Hospital and Michigan State University College of Human Medicine, Grand Rapids, Michigan 49503, USA.
J Ren Nutr. 2010 Mar;20(2):121-6. doi: 10.1053/j.jrn.2009.06.003. Epub 2009 Oct 22.
This study sought to evaluate the use of adult renal formulas in hyperkalemic infants with chronic kidney disease (CKD).
This was a retrospective, single-center cohort study.
This study took place at the Department of Pediatric Nephrology, Dialysis, and Transplantation at Helen DeVos Children's Hospital (Grand Rapids, MI).
Seven hyperkalemic infants (mean age, 6.9 months) comprised the study population: 29% with stage 3 CKD, 29% with stage 4 CKD, and 42% with stage 5 CKD.
Infants were empirically treated with adult renal formulas for an average duration of 9.6 months. Six of seven infants were started on breast milk or infant formula (Similac PM 60/40, Abbott Laboratories, Columbus, OH), but because of inadequate growth and hyperkalemia, were transitioned to adult renal formulas (Suplena, Abbott Laboratories, Columbus, OH; Nepro, Abbott Laboratories, Columbus, OH; and/or Renalcal, Nestle Nutrition, Minnetonka, MN). One infant received adult renal formula at birth.
The outcome measures included amount of potassium delivered by infant and adult renal formulas, level of serum potassium, and anthropometric measurements adjusted for age and gender (z-scores).
The transition from infant to adult renal formula resulted in a decrease in mean amount of potassium delivered by formula (from 2.6 to 1.0 mEq/kg/day, P < .001) and a decrease in mean serum potassium (from 5.1 to 4.0 mmol/L, P < .01). During treatment with adult renal formula, the infants demonstrated a significant increase in mean weight z-score (from -1.0 to 0.5, P < .01), height z-score (from -1.9 to -0.5, P < .01), and head-circumference z-score (from -1.5 to -1.0, P=.03). Adult renal formulas were well-tolerated.
Hyperkalemic infants with CKD can be nutritionally managed on adult renal formula.
本研究旨在评估在患有慢性肾脏病（CKD）的高钾血症婴儿中使用成人肾脏配方的效果。
这是一项回顾性、单中心队列研究。
本研究在密歇根州大急流城海伦·德沃斯儿童医院（Helen DeVos Children's Hospital）的儿科肾脏病、透析和移植科进行。
共有 7 名高钾血症婴儿（平均年龄 6.9 个月）入组本研究：29%处于 CKD 3 期，29%处于 CKD 4 期，42%处于 CKD 5 期。
婴儿平均接受了 9.6 个月的成人肾脏配方经验性治疗。7 名婴儿中有 6 名开始接受母乳或婴儿配方奶粉（Similac PM 60/40，雅培公司，哥伦布，俄亥俄州），但由于生长不良和高钾血症，他们转而接受成人肾脏配方（雅培公司的 Suplena、Nepro 和 Renalcal，雀巢营养，明尼苏达州明尼通卡）。1 名婴儿在出生时就接受了成人肾脏配方。
观察指标包括婴儿和成人肾脏配方所提供的钾量、血清钾水平以及经年龄和性别调整的人体测量学指标（z 评分）。
从婴儿配方到成人肾脏配方的转换导致配方所提供的平均钾量减少（从 2.6 至 1.0 mEq/kg/天，P <.001），血清钾水平降低（从 5.1 至 4.0 mmol/L，P <.01）。在接受成人肾脏配方治疗期间，婴儿的平均体重 z 评分显著增加（从-1.0 至 0.5，P <.01），身高 z 评分增加（从-1.9 至-0.5，P <.01），头围 z 评分增加（从-1.5 至-1.0，P=.03）。成人肾脏配方耐受良好。
患有 CKD 的高钾血症婴儿可以通过成人肾脏配方进行营养管理。
