Palma Pier Luigi, Sessa Anna Di, Passaro Antonio Paride, Palladino Eleonora, Furcolo Giuseppe, Barlabà Annalisa, Rivetti Giulio, Lucia Maeva De, Miraglia Del Giudice Emanuele, Guarino Stefano, Marzuillo Pierluigi
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Unità Operativa Complessa di Pediatria e Pronto Soccorso Pediatrico, AORN Moscati, 83100 Avellino, Italy.
Children (Basel). 2023 Jan 6;10(1):123. doi: 10.3390/children10010123.
The coronavirus disease 2019 (COVID-19) pandemic changed adults and children's lifestyle. We focused our attention on children affected by chronic kidney disease (CKD) due to congenital abnormalities of kidney and urinary tract (CAKUT) and their behavior during the lockdown. Our aims were to evaluate the incidence of CKD progression within 6 months after the end of the first Italian lockdown and the factors associated to it. CKD progression was defined by the transition to higher CKD stage or by the drop in estimated glomerular filtration rate by a 25% or more for patients belonging to CKD stages 1 and 2. We retrospectively selected 21 children with CAKUT and CKD ≥ stage 1 observed within 3 months before and 6 months after the first Italian lockdown. We called them by phone and asked them about their lifestyle before and during lockdown focusing on physical activity, screen time, sweet/candies/sugar-sweetened beverages eaten/drunk and adherence to the Mediterranean diet (MD) (through KIDMED questionnaire). We calculated and analyzed the delta between the pre- and post- lockdown observation of all collected parameters (clinical and biochemical parameters and questionnaires scores). Analyzing the overall cohort, we found significantly increased mean BMI and mean screen time and significantly lower mean physical activity time in post- compared with pre-lockdown observations. Eleven out of twenty-one patients (52.4%) had a worsening of CKD. These patients presented higher delta of levels of uric acid and microalbuminuria and showed minor adherence to the MD and declared to have consumed more sweets or candies or sugar-sweetened beverages/week during the lockdown with a tendentially major increment of BMI compared with patients not presenting CKD progression. In conclusion, the lockdown for COVID-19 pandemic determined increase of BMI in all enrolled patients due to a "forced" negative lifestyle. About half of these patients presented CKD progression. This progression was associated to less adherence to the MD and major consumption of sweets or candies or sugar-sweetened beverages.
2019年冠状病毒病（COVID-19）大流行改变了成人和儿童的生活方式。我们将注意力集中在因肾脏和尿路先天性异常（CAKUT）而患有慢性肾脏病（CKD）的儿童及其在封锁期间的行为上。我们的目的是评估意大利首次封锁结束后6个月内CKD进展的发生率及其相关因素。CKD进展的定义为：对于CKD 1期和2期的患者，进展到更高的CKD阶段，或估算肾小球滤过率下降25%或更多。我们回顾性选择了21例患有CAKUT且CKD≥1期的儿童，这些儿童在意大利首次封锁前3个月和封锁后6个月内接受观察。我们通过电话联系他们，询问他们在封锁前和封锁期间的生活方式，重点关注体育活动、屏幕使用时间、食用/饮用的甜食/糖果/含糖饮料以及对地中海饮食（MD）的依从性（通过KIDMED问卷）。我们计算并分析了所有收集参数（临床和生化参数以及问卷得分）在封锁前后观察值之间的差值。分析整个队列时，我们发现与封锁前的观察结果相比，封锁后的平均体重指数和平均屏幕使用时间显著增加，平均体育活动时间显著减少。21例患者中有11例（52.4%）的CKD病情恶化。这些患者的尿酸和微量白蛋白尿水平差值更高，对MD的依从性较差，并且宣称在封锁期间每周食用了更多的甜食或糖果或含糖饮料，与未出现CKD进展的患者相比，体重指数有增加的趋势。总之，COVID-19大流行期间的封锁由于“被迫”的不良生活方式导致所有入组患者体重指数增加。这些患者中约有一半出现了CKD进展。这种进展与对MD的依从性较低以及大量食用甜食或糖果或含糖饮料有关。
