Relationship between nutritional insufficiency and progression of acute kidney injury in children with signs of multiple organ failure

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Background. Acute kidney injury (AKI) remains one of the most common and severe forms of organ dysfunction in children in intensive care units. According to current data, the incidence of AKI in critically ill children reaches 30 to 50% and increases significantly in the presence of sepsis, systemic inflammatory response, multiple organ failure, and massive infusion therapy. Clinical and laboratory signs of AKI include a decrease in the rate of diuresis, an increase in creatinine levels, and disturbances in electrolyte and acid-base balances.

Objective. Assessment of the relationship between the nutritional deficiency and the progression of AKI in children in critical condition.

Material and methods. The study included 56 children with AKI, who were stratified into groups by the degree of protein-energy malnutrition. Anthropometric and laboratory parameters were assessed, including albumin and prealbumin levels, diuresis rate, and duration of renal dysfunction.

Results. A significant relationship between the severity of nutritional deficiency and the prolongation of the AKI period was established. Patients with severe protein-energy malnutrition had a significant decrease in protein markers, a longer course of oliguria, and an increased incidence of complications.

Conclusion. Nutritional deficiency has an adverse effect on the course of AKI in children. Protein metabolism markers can be used to assess prognosis and select treatment tactics in intensive care.

全文:

受限制的访问

作者简介

Gulchekhra Ashurova

Tashkent Pediatric Medical Institute; Tashkent State Medical University

编辑信件的主要联系方式.
Email: gulibaur@gmail.com
ORCID iD: 0000-0001-6437-8967
SPIN 代码: 7063-0126

Cand.Sci, (Med.), Teaching Assistant, Department of Anesthesiology and Resuscitation, Pediatric Anesthesiology and Resuscitation

乌兹别克斯坦, Tashkent; Tashkent

Ikhtiyor Mamatkulov

Tashkent Pediatric Medical Institute

Email: mikhtiyor77@mail.ru
ORCID iD: 0000-0003-4053-4544

Cand.Sci, (Med.), Associate Professor, Department of Anesthesiology and Resuscitation, Pediatric Anesthesiology and Resuscitation

乌兹别克斯坦, Tashkent

参考

  1. Аборин С.В., Печкуров Д.В., Захарова Л.И. Ранняя диагностика острого повреждения почек у глубоко недоношенных новорожденных с использованием мочевого биомаркера NGAL. Наука и инновации в медицине. 2017;2(4):47–52. doi: 10.35693/2500-1388-2017-0-4-47-52. [Aborin S.V., Pechkurov D.V., Zakharova L.I. Early diagnostics of acute kidney injury in very premature infants using urinary biomarker NGAL. Science and Innovations in Medicine. 2017;2(4):47–52. Doi: 10.35693/ 2500-1388-2017-0-4-47-52 (In Russ.)].
  2. Добрынин А.С. Белково-энергетическая недостаточность и саркопения при острой церебральной недостаточности. Клиническое питание и метаболизм. 2024;5(2):51–8. Doi: https://doi.org/10.17816/clinutr643360. [Dobrynin A.S. Protein-energy malnutrition and sarcopenia in acute cerebral failure. Clinical Nutrition and Metabolism. 2024;5(2):51–8. Doi: https://doi.org/10.17816/clinutr643360 (In Russ.)].
  3. Ерпулева Ю. В. Современная организация нутритивной поддержки у детей с хирургической подготовкой. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2019;9(3):102–9. https://doi.org/10.30946/2219–4061–2019–9–3–102–109. [Erpuleva Yu. V. Modern organization of nutritional support in children with surgical pathology. Russian Bulletin of Pediatric Surgery, Anesthesiology and Resuscitation. 2019;9(3):102–9. https://doi.org/10.30946/ 2219–4061–2019–9–3–102–109 (In Russ.)].
  4. Луфт В.М., Шляпников С.А., Демко А.Е. и др. Особенности энергетического и белкового обеспечения больных при сепсисе: ретроспективное наблюдательное исследование. Вестник интенсивной терапии им. А.И. Салтанова. 2022;4:101–10. https://doi.org/10.21320/1818-474X-2022-4-101-110. [Luft V.M., Shlyapnikov S.A., Demko A.E. et al. Features of energy and protein support of patients with sepsis: a retrospective observational study. Bulletin of Intensive Care named after A. I. Saltanov. 2022;4:101–10. https://doi.org/10.21320/1818-474X-2022-4-101-110 (In Russ.)].
  5. Мавлянова З.Ф. Диагностика белково-энергетической недостаточности у детей с церебральным параличом. Экспериментальная и клиническая гастроэнтерология. 2023;215(7): 46–52. Doi: 10.31146/ 1682-8658-ecg-215-7-46-52. [Mavlyanova Z. F. Diagnosis of protein-energy malnutrition in children with cerebral palsy. Experimental and clinical gastroenterology. 2023;215(7): 46–52. Doi: 10.31146/ 1682-8658-ecg-215-7-46-52. (In Russ.)].
  6. Насонова С.Н., Жиров И.В., Ледяхова М.В. и др. Ранняя диагностика острого почечного повреждения у пациентов с острой декомпенсацией хронической сердечной недостаточности. Терапевтический архив. 2019;91(4):67–73. doi: 10.26442/00403660.2019.04.000168. [Nasonova S.N., Zhirov I.V., Ledyakhova M.V. et al. Early diagnosis of acute kidney injury in patients with acute decompensation of chronic heart failure. Therapeutic archive. 2019;91(4):67–73. doi: 10.26442/00403660.2019.04. 000168. (In Russ.)].
  7. Остерманн М. Острое повреждение почек у пациентов в критическом состоянии как общемировая проблема. Вестник анестезиологии и реаниматологии. 2019;16(2):83–95. https://doi.org/10.21292/2078-5658-2019-16-2-83-95. [Ostermann M. Acute kidney injury in critically ill patients as a global problem. Bulletin of Anesthesiology and Reanimatology. 2019;16(2):83–95. https://doi.org/10.21292/2078-5658-2019-16-2-83-95 (In Russ.)].
  8. Савенкова Н.Д. Педиатрические классификации и эпидемиология острого повреждения почек. Российский вестник перинатологии и педиатрии. 2018;3(5): 36–42. doi: 10.21508/1027–4065–2018–63–5–36–42. [Savenkova N.D. Pediatric classifications and epidemiology of acute kidney injury. Russian Bulletin of Perinatology and Pediatrics. 2018;3(5): 36–42. doi: 10.21508/1027–4065–2018–63–5–36–42 (In Russ.)].
  9. Сатвалдиева Э.А., Ашурова Г.З. Нутритивная терапия белково-энергетической недостаточности при сепсисе у детей. Клиническое питание и метаболизм. 2022;3(4):217–29. doi: 10.17816/clinutr111170. [Satvaldeva E.A., Ashurova G.Z. Nutritional therapy of protein-energy malnutrition in sepsis in children. Clinical Nutrition and Metabolism. 2022;3(4):217–29. doi: 10.17816/clinutr111170 (In Russ.)].
  10. Селиверстова А.А., Савенкова Н.Д., Хубулава Г.Г. и др. Острое повреждение почек у новорожденных и детей грудного возраста с врожденными пороками сердца после кардиохирургических вмешательств. Нефрология. 2017;21(3):54–60. https://doi.org/10.24884/1561-6274-2017-3-54-60. [Seliverstova A.A., Savenkova N.D., Khubulava G.G. et al. Acute kidney injury in newborns and infants with congenital heart defects after cardiac surgery. Nephrology. 2017;21(3):54–60. https://doi.org/10.24884/ 1561-6274-2017-3-54-60 (In Russ.)].
  11. Фомина М.В., Боровик Т.Э., Яцык С.П. и др. Особенности нутритивного статуса детей, поступающих на лечение в хирургическое торакальное отделение. Педиатрия. Consilium Medicum. 2023;1:86–94. doi: 10.26442/26586630.2023.1.202130. [Fomina M.V., Borovik T.E., Yatsyk S.P. et al. Features of the nutritional status of children admitted for treatment to the surgical thoracic department. Pediatrics. Consilium Medicum. 2023;1:86–94. doi: 10.26442/26586630.2023.1.202130 (In Russ.)].

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Average duration of mechanical ventilation by group

下载 (46KB)
索引源数据
3. Fig. 2. Average length of ICU stay by group

下载 (45KB)
索引源数据