Assessment of Nutritional Status of Children with CKD on Maintenance Haemodialysis in Baghdad City

  • Manar A Mehdi Ministry of Health, Baghdad, Iraq.
  • Yossra Khalaf Hanoon Department of Family and Community Medicine, College of Medicine, Al-mustansiriya University.
Keywords: Haemodialysis, CKD, Baghdad, Body Mass Index, Kidney


Background: Chronic kidney disease is a worldwide major public health problem. Most of the data related to the epidemiology of this condition during childhood focuses on the severe and late stages of renal impairment which is associated with malnutrition. It is an influential problem among those children and is essential to be recognised as early as possible.
Objectives: To assess the nutritional status of children with chronic kidney disease on haemodialysis using anthropometric measurements.
Patients and Method: A cross-sectional study was conducted in three randomly selected dialysis centres in Baghdad, the capital of Iraq, on a sample of patients with chronic kidney disease who attended these dialysis centres. Direct interviews were used to collect data during the period of the study which extended from the 15th of January to the 15th of July 2019.
Results: This study enrolled 140 children. The mean age of the respondents was 9.9 ± 3.6 years and 42.9% of them had an age range of 10-14 years. 57.1% of the study sample was diagnosed with the disease since 5-9 years, and 42.1% were on HD for 12-23 months. 37.1% of the sample were thin for age according to their gender, and 72.2% of them were stunted and severely stunted. Conclusions:A considerable proportion (75%) of children with chronic kidney disease were undernourished, with a significant percentage of the study sample detected with chronic malnutrition (stunted and severely stunted).

How to cite this article:
Mehdi MA, Hanoon YK. Assessment of Nutritional Status of Children with CKD on Maintenance Haemodialysis in Baghdad city. J Commun Dis. 2022;54(1):107-116.



Mak RH, Cheung WW, Zhan JY, Shen Q, Foster BJ. Cachexia and protein-energy wasting in children with chronic kidney disease. Pediatr Nephrol. 2012 Feb;27(2):173-81. [PubMed] [Google Scholar]

Kent PS, McCarthy MP, Burrowes JD, McCann L, Pavlinac J, Goeddeke-Merickel CM, Wiesen K, Kruger S, Byham-Gray L, Pace RC, Hannahs V, Benner D. Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition. J Acad Nutr Diet. 2014 Sep;114(9):1448-57. [PubMed] [Google Scholar]

Ayestaran FW, Schneider MF, Kaskel FJ, Srivaths PR, Seo-Mayer PW, Moxey-Mims M, Furth SL, Warady BA, Greenbaum LA. Perceived appetite and clinical outcomes in children with chronic kidney disease. Pediatr Nephrol. 2016 Jul;31(7):1121-7. [PubMed] [Google Scholar]

Apostolou A, Printza N, Karagiozoglou-Lampoudi T, Dotis J, Papachristou F. Nutrition assessment of children with advanced stages of chronic kidney disease-asingle center study. Hippokratia. 2014 Jul;18(3):212. [PubMed] [Google Scholar]

Duggan C, Watkins JB, Koletzko B, Walker WA, editors. Nutrition in pediatrics: basic science, clinical applications. Vol 1. PMPH USA Ltd; 2016. [Google Scholar]

Gunal AI. How to determine ‘dry weight? Kidney Int Suppl. 2013 Dec;3(4):377-9. [PubMed] [Google Scholar]

Gandy J, editor. Manual of dietetic practice. John Wiley & Sons; 2019. [Google Scholar]

Gao T, Leonard MB, Zemel B, Kalkwarf HJ, Foster BJ. Interpretation of body mass index in children with CKD. Clin J Am Soc Nephrol. 2012 Apr;7(4):558-64. [PubMed] [Google Scholar]

Mansourian M, Marateb HR, Kelishadi R, Motlagh ME, Aminaee T, Taslimi M, Majdzadeh R, Heshmat R, Ardalan G, Poursafa P. First growth curves based on the World Health Organization reference in a Nationally- Representative Sample of Pediatric Population in the Middle East and North Africa (MENA): the CASPIAN-III study. BMC Pediatr. 2012 Dec;12(1):149. [PubMed] [Google Scholar]

Martinez-Millana A, Hulst JM, Boon M, Witters P, Fernandez-Llatas C, Asseiceira I, Calvo-Lerma J, Basagoiti I, Traver V, De Boeck K, Ribes-Konickx C. Optimisation of children z-score calculation based on new statistical techniques. PloS One. 2018;13(12):e0208362. [PubMed] [Google Scholar]

Foster BJ, McCauley L, Mak RH. Nutrition in infants and very young children with chronic kidney disease. Pediatr Nephrol. 2012;27(9):1427-39. [PubMed] [Google Scholar]

Ali SH, Ali AT, Hasan AA. Etiology of chronic kidney disease in children in three Pediatric Nephrology Centers in Baghdad. Int J Curr Microbiol App Sci. 2019;8(1):1547-55. [Google Scholar]

Tan SY, Naing L, Han A, Khalil MA, Chong VH, Tan J. Chronic kidney disease in children and adolescents in Brunei Darussalam. World J Nephrol. 2016;5(2):213-9. [PubMed] [Google Scholar]

Iorember FM. Malnutrition in chronic kidney disease. Front Pediatr. 2018;6:161. [PubMed] [Google Scholar]

Tu J, Cheung WW, Mak RH. Inflammation and nutrition in children with chronic kidney disease. World J Nephrol. 2016;5(3):274. [PubMed] [Google Scholar]

Bonthuis M, van Stralen KJ, Verrina E, Groothoff JW, Melgar ÁA, Edefonti A, Fischbach M, Mendes P, Molchanova EA, Paripović D, Peco-Antic A, Printza N, Rees L, Rubik J, Stefanidis CJ, Sinha MD, Zagożdżon I, Jager KJ, SchaeferF. Underweight, overweight and obesity in paediatric dialysis and renal transplant patients. Nephrol Dial Transplant. 2013;28(suppl4):iv195-iv204. [PubMed] [Google Scholar]

Mastrangelo A, Paglialonga F, Edefonti A. Assessment of nutritional status in children with chronic kidney disease and on dialysis. Pediatr Nephrol. 2014;29(8):1349-58. [PubMed] [Google Scholar]

Haffner D, Fischer DC. Growth and pubertal development in dialyzed children and adolescents. In: Warady B, Schaefer F, Alexander S, editors. Pediatric Dialysis.Springer; 2012. p. 453-81. [Google Scholar]

Haffner D, Zivicnjak M. Pubertal development in children with chronic kidney disease. Pediatr Nephrol. 2017;32(6):949-64. [PubMed] [Google Scholar]

Rogol AD, Hayden GF. Etiologies and early diagnosis of short stature and growth failure in children and adolescents. JPediatr. 2014 May;164(5):S1-4. [PubMed] [Google Scholar]

Souilmi FZ, Houssaini TS, El Bardai G, Kabbali N, Arrayhani M, Hida M. The fate of patients who started hemodialysis during childhood or adolescence: results of an interregional Moroccan Survey. Int Sch Res Notices. 2014;2014:389729. [PubMed] [Google Scholar]

de Camargo MF, Henriques CL, Vieira S, Komi S, Leao ER, Nogueira PC. Growth of children with end-stage renal disease undergoing daily hemodialysis. Pediatr Nephrol. 2014;29(3):439-44. [PubMed] [Google Scholar]