title: Perceived appetite and clinical outcomes in children with chronic kidney disease.
abstract: Children with chronic kidney disease (CKD) may have impaired caloric intake through a variety of mechanisms, with decreased appetite as a putative contributor. In adult CKD, decreased appetite has been associated with poor clinical outcomes. There is limited information about this relationship in pediatric CKD.
  
  
  
  A total of 879 participants of the Chronic Kidney Disease in Children (CKiD) study were studied. Self-reported appetite was assessed annually and categorized as very good, good, fair, or poor/very poor. The relationship between appetite and iohexol or estimated glomerular filtration rate (ieGFR), annual changes in anthropometrics z-scores, hospitalizations, emergency room visits, and quality of life were assessed.
  
  
  
  An ieGFR < 30 ml/min per 1.73 m(2) was associated with a 4.46 greater odds (95 % confidence interval: 2.80, 7.09) of having a worse appetite than those with ieGFR >90. Appetite did not predict changes in height, weight, or BMI z-scores. Patients not reporting a very good appetite had more hospitalizations over the next year than those with a very good appetite. Worse appetite was significantly associated with lower parental and patient reported quality of life.
  
  
  
  Self-reported appetite in children with CKD worsens with lower ieGFR and is correlated with clinical outcomes, including hospitalizations and quality of life.
authors: Division of Pediatric Nephrology, Emory University, 2015 Uppergate Drive, NE, Atlanta, GA, 30322, USA. frankayestar@health.usf.edu.|Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA. frankayestar@health.usf.edu.
authors: Frank W
authors: FW
authors: Ayestaran
authors: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Michael F
authors: MF
authors: Schneider
authors: Albert Einstein School of Medicine, New York, NY, USA.
authors: Frederick J
authors: FJ
authors: Kaskel
authors: Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
authors: Poyyapakkam R
authors: PR
authors: Srivaths
authors: Pediatric Specialists of Virginia and Georgetown University Hospital, Fairfax, VA, USA.
authors: Patricia W
authors: PW
authors: Seo-Mayer
authors: National Institute of Diabetes and Digestive Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
authors: Marva
authors: M
authors: Moxey-Mims
authors: Children's Hospital Pennsylvania, Philadelphia, PA, USA.|Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
authors: Susan L
authors: SL
authors: Furth
authors: Children's Mercy Hospital, Kansas City, MO, USA.
authors: Bradley A
authors: BA
authors: Warady
authors: Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors: Larry A
authors: LA
authors: Greenbaum
mesh_terms: D000293:Adolescent; D001066:Appetite; D002648:Child; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000150:complications*
keywords: ER visits; Hospitalization; Nutrition; Pediatric; Quality of life; Renal function