Micronutrient Status in Children with Chronic Kidney Disease

Micronutrient status in children with chronic kidney disease (CKD)

Pallavi Yadav, Simon Waller Evelina Childrens Hospital, London

To obtain baseline data of micronutrient profile in children with CKD, pre-renal replacement, with a view to supplement deficiencies. To establish the appropriateness to monitor micronutrients in children with CKD

Methods Single-centre retrospective observational study. Data including weight, height, estimated glomerular filtration rate (eGFR), serum levels of copper, zinc, selenium, vitamin B12 and folate were collected from 45 children. Patients were attending a tertiary nephrology CKD clinic, for children with CKD stages 3-5

RESULTS: The study comprised 25 girls/20 boys. Of the 45 children 13(28%) were CKD stage 4, 41(68%) were suffering CKD stage 3, 1(2%) was CKD stage 5

None of the children showed any deficiency or excess of folate, B12, copper, selenium. However 13/45 (28%) had sub-normal serum zinc levels. In children with zinc deficiency 8/13 (62%) were CKD stage 4. Our only child in CKD stage 5 was zinc replete. Two zinc deficient patients were failing to thrive.

CONCLUSIONS: Data profiling micronutrient status in children on haemodialysis is published; there is no established guidance on monitoring /supplementing children with CKD pre-renal replacement. Our pilot data suggests that minimal micronutrient monitoring is required; but does demonstrate that zinc deficiency was present in more than 1/4th of participants. Low circulating zinc concentrations have been previously reported in CKD; as a consequence of low-protein diet/intake. Low levels have been associated with atherosclerosis and mood variations in CKD patients. As symptoms of zinc deficiency are complex, non-specific and can trigger uraemic complications it would be useful to monitor levels.