title: Underweight, overweight and obesity in paediatric dialysis and renal transplant patients.
abstract: BACKGROUND
  The prevalence of childhood overweight is rising worldwide, but in children on renal replacement therapy (RRT) a poor nutritional status is still the primary concern. We aimed to study the prevalence of, and factors associated with, underweight and overweight/obesity in the European paediatric RRT population. Moreover, we assessed the evolution of body mass index (BMI) after the start of RRT.
  
  
  METHODS
  We included 4474 patients younger than 16 years from 25 countries of whom BMI data, obtained between 1995 and 2010, were available within the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry. Prevalence estimates for under- and overweight/obesity were calculated using age and sex-specific criteria of the World Health Organization (WHO, 0-1 year olds) and the International Obesity Task Force cut-offs (2-15 year olds).
  
  
  RESULTS
  The prevalence of underweight was 3.5%, whereas 20.8% of the patients were overweight and 12.5% obese. Factors associated with being underweight were receiving dialysis treatment and infant age. Among transplanted recipients, a very short stature (OR: 1.64, 95% CI: 1.40-1.92) and glucocorticoid treatment (OR: 1.23, 95% CI: 1.03-1.47) were associated with a higher risk of being overweight/obese. BMI increased post-transplant, and a lower BMI and a higher age at the start of RRT were associated with greater BMI changes during RRT treatment.
  
  
  CONCLUSIONS
  Overweight and obesity, rather than underweight, are highly prevalent in European children on RRT. Short stature among graft recipients had a strong association with overweight, while underweight appears to be only a problem in infants. Our findings suggest that nutritional management in children receiving RRT should focus as much on the prevention and treatment of overweight as on preventing malnutrition.
authors: ESPN/ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Marjolein
authors: M
authors: Bonthuis
authors: Karlijn J
authors: KJ
authors: van Stralen
authors: Enrico
authors: E
authors: Verrina
authors: Jaap W
authors: JW
authors: Groothoff
authors: Ángel
authors: Á
authors: Alonso Melgar
authors: Alberto
authors: A
authors: Edefonti
authors: Michel
authors: M
authors: Fischbach
authors: Patricia
authors: P
authors: Mendes
authors: Elena A
authors: EA
authors: Molchanova
authors: Dušan
authors: D
authors: Paripović
authors: Amira
authors: A
authors: Peco-Antic
authors: Nikoleta
authors: N
authors: Printza
authors: Lesley
authors: L
authors: Rees
authors: Jacek
authors: J
authors: Rubik
authors: Constantinos J
authors: CJ
authors: Stefanidis
authors: Manish D
authors: MD
authors: Sinha
authors: Ilona
authors: I
authors: Zagożdżon
authors: Kitty J
authors: KJ
authors: Jager
authors: Franz
authors: F
authors: Schaefer
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology; D050177:Overweight / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D006435:Renal Dialysis; D012307:Risk Factors; D013851:Thinness / Q000453:epidemiology* / Q000503:physiopathology
keywords: children; nutritional status; overweight; renal replacement therapy; underweight