Impacto de la suplementación proteico-calórica oral intradiálisis en la evolución nutricional de pacientes menores de 18 años con enfermedad renal crónica, Hospital del Niño Dr. Francisco De Icaza Bustamante, período septiembre 2025 a marzo 2026.

Abstract

Background: The burden of childhood malnutrition remains high in Latin America. According to international data, 50–60% of patients with end-stage kidney disease (ESKD) undergoing dialysis have some degree of malnutrition, which is associated with an increased risk of infections and hospitalization. Intradialytic nutritional supplementation has been shown to be a useful and safe strategy for the nutritional management of these patients. Objective: To assess the impact of intradialytic oral protein calorie supplementation on the nutritional status of patients younger than 18 years with ESKD treated at the Dr. Francisco de Icaza Bustamante Children’s Hospital between September 2025 and March 2026. Materials and Methods: This observational, longitudinal, prospective study included pediatric patients with ESKD who underwent nutritional assessment and received intradialytic oral protein calorie supplementation for 6 months. Data were analyzed using SPSS. Results: Overall, 86.1% of the patients had malnutrition, and 16.1% met the criteria for protein energy wasting (PEW). Following the intervention, a modest improvement in weight and linear growth was observed. Mean body weight increased from 24.91 ± 10.45 kg in December to 25.60 ± 10.28 kg in March, while mean height increased from 120.76 ± 20.60 cm to 122.91 ± 19.53 cm. The height for age Z score improved by an average of 0.31 standard deviations, whereas BMI/weight for height remained stable. Serum albumin increased by 0.36 g/dL, with a p value of 0.027, representing a clinically relevant finding given its association with a favorable clinical prognosis. No significant deterioration in metabolic or kidney related bi ochemical parameters was observed, suggesting that supplementation provided nutritional and biochemical benefits without compromising metabolic or renal safety. Conclusion: Intradialytic oral nutritional supplementation was associated with favorable change s in the nutritional status of pediatric patients with ESKD, including increases in body weight, height, and serum albumin levels, without adverse changes in metabolic or kidney related biochemical markers. These findings support its potential usefulness a nd safety as part of the nutritional management of pediatric patients undergoing dialysis.