Nutritional Requirements for Infants With Renal Failure

HE CARE of infants with chronic renal failure (CRF) is an area of special concern for pediatricians and pediatric nephrologists Nor­ mally, growth rates are highest during the first 2 year s of life Length increases by 50 %, weight is quadrupled, and under the influence of brain growth, head circumference increases by 40 %. Studies have repeatedly shown that when impair­ ment of renal function occurs either at, or shortly after birth, growth and development are pro­ foundly affected. I 3 Of equal importance for the majority of these children, growth lost during this critical period is not regained . In the past, these observations were of only academi c interest, since no effective therapy was available. Most pediatric centers reported poor results with renal transplan­ tation in children under 10 kg in body weight>; with few exceptions, chronic hemodialysis was not performed in infants In this setting , growth was further compromised due to a combination of anorexia coupled with concerns about increased food intake leading to an exacerbation of uremic symptoms. Shortly after continuous ambulatory peritoneal dialysis (CAPD) was described by Popovich et al,? several centers began this form of treatment in children .s'? CAPD and a related form of dialysi s, continuous cyclic peritoneal dialysis (CCPD) have been used. Results are similar and in this report they will be collectively referred to as continuous