Sabina S Kennedy1, Ashley Perilloux2, Renata C Pereira3, Garry Handelman4, Katherine Wesseling-Perry3, Isidro B Salusky5. 1. Department of Pediatrics, Emory University/Children's Hospital of Atlanta, Druid Hills, USA. 2. DaVita Century City Dialysis, Los Angeles, USA. 3. Division of Pediatric Nephrology, Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Box, Los Angeles, 951752, USA. 4. Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, USA. 5. Division of Pediatric Nephrology, Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Box, Los Angeles, 951752, USA. isalusky@mednet.ucla.edu.
Abstract
BACKGROUND: Malnutrition and anorexia are common in children with chronic kidney disease (CKD) and gastrostomy tubes (GT) as well as nasogastric tubes (NGT) have been recommended to maximize nutritional support. The optimal requirement of vitamin C in children with CKD remains to be defined but oxalate is a breakdown product of vitamin C. Elevated vitamin C intake and bone oxalate were identified in two formula-fed dialyzed children with negative genetic testing for primary hyperoxaluria. METHODS: We evaluated the impact of nutritional support on serum ascorbic acid and plasma oxalate levels in 13 dialyzed infants and young children. RESULTS: All patients were fed by GT or NGT since the first months of life; overall patients were receiving between 145 and 847% of the age-specific DRI for vitamin C. Mean serum ascorbic acid and plasma oxalate levels were elevated (244.7 ± 139.7 μM/L and 44.3 ± 23.1 μM/L, respectively), and values did not differ according to the degree of residual kidney function. Ascorbic acid levels did not correlate with oxalate levels (r = 0.44, p = 0.13). CONCLUSIONS: Excessive vitamin C intake may contribute to oxalate accumulation in dialyzed children.
BACKGROUND: Malnutrition and anorexia are common in children with chronic kidney disease (CKD) and gastrostomy tubes (GT) as well as nasogastric tubes (NGT) have been recommended to maximize nutritional support. The optimal requirement of vitamin C in children with CKD remains to be defined but oxalate is a breakdown product of vitamin C. Elevated vitamin C intake and bone oxalate were identified in two formula-fed dialyzed children with negative genetic testing for primary hyperoxaluria. METHODS: We evaluated the impact of nutritional support on serum ascorbic acid and plasma oxalate levels in 13 dialyzed infants and young children. RESULTS: All patients were fed by GT or NGT since the first months of life; overall patients were receiving between 145 and 847% of the age-specific DRI for vitamin C. Mean serum ascorbic acid and plasma oxalate levels were elevated (244.7 ± 139.7 μM/L and 44.3 ± 23.1 μM/L, respectively), and values did not differ according to the degree of residual kidney function. Ascorbic acid levels did not correlate with oxalate levels (r = 0.44, p = 0.13). CONCLUSIONS: Excessive vitamin C intake may contribute to oxalate accumulation in dialyzed children.
Authors: C L Benhamou; T Bardin; D Tourlière; L Voisin; M Audran; C Edouard; M H Lafage; J L Sebert; M C de Vernejoul; D Wendling Journal: Rev Rhum Mal Osteoartic Date: 1991-11-30
Authors: Patrick Chaghouri; Nour Maalouf; Sophia Lorina Peters; Piotr Jan Nowak; Katarzyna Peczek; Anna Zasowska-Nowak; Michal Nowicki Journal: Nutrients Date: 2021-02-27 Impact factor: 5.717