الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is commonly labelled as a silent killer associated with multiple comorbid conditions. In children with kidney diseases, an assessment of the child’s growth and nutritional status is important to guide the dietary prescription. No single metric can comprehensively describe the nutrition status; therefore, a series of indices and tools are required for evaluation. Nutritional intake is a common concern in children with CKD, and this often leads to severe growth retardation. Maintaining adequate nutrition and normal body composition is important for patients with chronic kidney disease (CKD) as well as those with end-stage renal disease (ESRD). This study was carried out to assess the growth and the nutritional status in children with CKD as a primary outcome and to correlate their nutritional status with dialysis duration, age, sex and socio-economic state using anthropometric measurements To assess the growth and the nutritional status in children with CKD and to correlate it with different variables (anthropometric measurements and duration of CKD This is a community based cross sectional study carried out on 40 child attending Pediatric Nephrology unite at Asyut university Pediatric Hospital diagnosed as chronic kidney disease. Their age ranged from 2 year to 15 year. The time of the study was 12 months from January 2021-end of December2021.They were 23 males & 17 females. Patients were subjected to full history taking including dietary intake, full medical examination including anthropometric measurements, and laboratory investigations including complete blood picture, serum calcium, phosphorus, and serum albumin. Data were collected, tabulated and statistically analyzed The study revealed that; weight was the most affected anthropometric parameter, as 80% of the patients were < 5th percentile (mean 26.77 ±11.68), height is less affected than weight, as 72.5% of patients were less than 5th percentile (mean 124.52± 17.81). In addition the body mass index of 80% of the patient were < 5th percentile, while only 20% of the patient were normal range and no one were > 50th percentile. The BMI ranged from 12.11-20.13 (mean 16.12±4.01).This retardation was significantly related to duration of CKD, male sex patients, age <5years and low socio-economic state. There are various causes of malnutrition and inadequate linear growth in children with CKD. Growth of patients with CKD is markedly affected despite of adequacy of their protein and caloric intake. The longer the duration of hemodialysis, the younger age and the low socio-economic state together with male sex the more severe the affection of growth parameters The most important first step to ameliorate these co-morbidities is to recognize and address their etiologies of these co-morbidities, using currently available methods and tools. It is essential to also understand the interplay between nutrition and growth. The next step is to devise an individualized treatment that requires continuous re-assessment. While advances have been made with identifying risk factors and providing improved therapy, enhanced recognition of these co-morbid conditions is essential for improved outcome. Children with CKD should be firstly assessed for nutritional risk. In this setting not a defined tool is suitable for every situation, even if STRONG kids score appear to be the most quick, reliable and practical to use since from the admission in the hospital. As a high risk of malnutrition is found in a child CKD or adolescent, a nutritional global assessment must be performed by a pediatrician or a clinical nutritionist. For this purpose, medical and dietary history, physical examination and anthropometric measurements are well accepted and validated methods. Every effort should be carried out to early identify and promptly correct malnutrition among children with CKD.