Croissance et nutrition de l’enfant en dialyse péritonéale

  • Ariane Zaloszyc Pédiatrie 1, CHU de Hautepierre, Hôpitaux universitaires de Strasbourg, 67000 Strasbourg https://orcid.org/0000-0002-2771-0999
  • Saoussen Krid Néphrologie pédiatrique, Hôpital Necker-Enfants Malades, 75015 Paris
  • Bruno Ranchin Centre de Référence Maladies Rénales Rares « Néphrogones », Service de Néphrologie et Rhumatologie Pédiatrique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69677 Bron cedex
Mots-clés: dialyse péritonéale, pédiatrie, enfant, retard croissance, nutrition, malnutrition

Résumé

Le retard de croissance et la dénutrition sont fréquents chez l’enfant atteint de maladie rénale chronique et s’accentuent avec le degré de l’atteinte pour être maximaux chez l’enfant au stade de dialyse, conduisant à un risque de surmortalité. Malgré de nombreux progrès réalisés dans le domaine de la dialyse pédiatrique, la petite taille à l’âge adulte reste très commune dans cette population. L’origine de la dénutrition et du retard de croissance est complexe et multifactorielle. Chez le nourrisson en dialyse péritonéale, les apports nutritionnels insuffisants sont reconnus comme un frein majeur à la croissance adéquate. L’approche diagnostique de la dénutrition et du retard de croissance de l’enfant en dialyse péritonéale nécessite de s’appuyer sur plusieurs éléments : un interrogatoire, un examen clinique, et des examens complémentaires divers. En raison de l’aspect multifactoriel du statut nutritionnel et statural de l’enfant, plusieurs axes thérapeutiques sont à prendre en compte, à savoir un traitement nutritionnel adapté aux besoins de l’enfant, un traitement par hormone de croissance, et une optimisation de la dialyse pour permettre un contrôle métabolique optimal.

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Publiée
2019-06-14