Ruley E J, Bock G H, Kerzner B, Abbott A W, Majd M, Chatoor I
Department of Nephrology, Children's Hospital National Medical Center, George Washington University School of Medicine, Washington, DC 20010.
Pediatr Nephrol. 1989 Oct;3(4):424-9. doi: 10.1007/BF00850220.
Twenty-two infants (mean age 7.5 months) with chronic renal failure (CRF) were studied for their nutrition, growth, and upper gastrointestinal function. Most infants had a history of poor caloric intake and 7 had received supplemental feeding (SF) prior to the investigation. All infants were undergrown, underweight, and malnourished. The infants were characterized as having only a fair interest in food, refusing feedings, and vomiting excessively. Sixteen of 22 infants (73%) had significant gastroesophageal (GE) reflux demonstrated by 24-h esophageal pH monitoring. Gastroesophageal scintiscans were less sensitive and specific in detecting the reflux. Infants with GE reflux were significantly younger and more often required SF than those without GE reflux. There were no significant differences in the degree of renal failure, growth failure, caloric intake, protein intake, or nutritional status between the infants with and without GE reflux. From these studies we conclude that GE reflux should be considered as one of the factors contributing to the feeding problems of infants with CRF.
对22名慢性肾衰竭（CRF）婴儿（平均年龄7.5个月）的营养、生长及上消化道功能进行了研究。大多数婴儿有热量摄入不足史，7名婴儿在调查前接受过补充喂养（SF）。所有婴儿均生长发育迟缓、体重不足且营养不良。这些婴儿的特点是对食物兴趣一般、拒食且过度呕吐。22名婴儿中有16名（73%）经24小时食管pH监测显示有明显的胃食管（GE）反流。胃食管闪烁扫描在检测反流方面敏感性和特异性较低。有GE反流的婴儿比无GE反流的婴儿年龄显著更小，且更常需要补充喂养。有和无GE反流的婴儿在肾衰竭程度、生长发育迟缓、热量摄入、蛋白质摄入或营养状况方面无显著差异。从这些研究中我们得出结论，应将GE反流视为导致CRF婴儿喂养问题的因素之一。
