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Biomedical subjects

M Kriley

Publications and source records attributed to M Kriley.

5 recordsLinked to original sources

Vitamin status of infants receiving long-term peritoneal dialysis.

The oral vitamin intakes and blood vitamin concentrations of seven infants receiving long-term peritoneal dialysis were measured. The serum concentrations of vitamin A, vitamin B12, vitamin C and folic acid were determined. Thiamine and riboflavin were assessed by the activation of erythrocyte transketolase and erythrocyte glutathione reductase, respectively. Vitamin B6 was measured as plasma pyridoxal phosphate. All patients received a daily vitamin supplement devoid of vitamin A. Dietary vitamin intake was derived from infant formula. In all cases, the patients' blood concentrations of the water-soluble vitamins were equal to or greater than normal infant values. Serum vitamin A levels were elevated despite the lack of supplementation. The combined dietary/supplemental water-soluble vitamin intake of the patients exceeded the recommended daily allowance in all but one patient. These preliminary data emphasize the need to further evaluate the vitamin requirements of infants receiving long-term peritoneal dialysis.

Diet↗

Vitamin status of pediatric patients receiving long-term peritoneal dialysis.

The oral vitamin intakes and concentrations of vitamins in blood of eight children on long-term peritoneal dialysis and six control children were measured. All patients received a daily supplement containing water-soluble vitamins. Serum concentrations of vitamin A, vitamin B-12, ascorbic acid, and folic acid and dialysate concentrations of ascorbic acid were determined. Thiamin and riboflavin were assessed by measuring erythrocyte enzyme activities. Vitamin B-6 was measured as plasma pyridoxal phosphate. Dietary vitamin intake was determined with weighed 3-d food records. The dialysis patients had significantly greater stores of vitamin A, thiamin, riboflavin, pyridoxal phosphate, and folic acid than did the control population (P less than or equal to 0.01). The patients' combined dietary and supplemental intake of all vitamins except ascorbic acid was also significantly greater than the intake of the control group (P less than 0.01). Vitamin supplementation is associated with normal or greater-than-normal values of water-soluble vitamins in pediatric patients receiving long-term peritoneal dialysis.

Child↗

Nutritional and behavioural aspects of nasogastric tube feeding in infants receiving chronic peritoneal dialysis.

Eight infants initiated chronic peritoneal dialysis and received nasogastric tube feedings during their first month of life. In each case, the nasogastric tube feedings were initiated because of poor oral intake and the desire to avert the development of an aversive feeding interaction between parent and child. The nutritional regimen was designed to allow normal or catch up weight gain appropriate for height age. The caloric and protein intake of the infants averaged 98.5 +/- 10.2 kcal/kg/day and 2.7 gm/kg/day, respectively, during the first year of life. Between 25% and 100% of the formula intake was provided by the nasogastric route. Group standard deviation score for height was -1.74 +/- 0.7 at one year. Five of the infants received behavioral therapy because of persistent food refusal. Therapy consisted of reinforcing prompted food acceptance and ignoring food refusal. This approach was conducted by a multidisciplinary team and successfully converted the non-oral feeder to a total oral feeding regimen in each case.

Enteral Nutrition↗

Growth and development of infants with end-stage renal disease receiving long-term peritoneal dialysis.

The growth and development of four infants with end-stage renal disease receiving long-term peritoneal dialysis was studied during the first year of life. In each patient, dialysis was begun before 4 weeks of age. A nutritional regimen was designed to attain a daily weight gain appropriate for height age while minimizing the blood urea nitrogen level. A neurodevelopmental evaluation of gross and fine motor, cognitive, language, and psychosocial skills was performed at least every 3 months. At age 1 year, the mean height standard deviation score (SDS) was -1.33 +/- 0.2. Weight for height was greater than 95th percentile in one patient and normal in three. Mean caloric and protein intake were 105 +/- 20 kcal/kg/d (11.4 +/- 2.7 kcal/cm/d) and 2.7 g/kg/d (0.30 +/- 0.11 g/cm/d), respectively. Mean blood urea nitrogen was 53.6 +/- 17.8 mg/dL. Developmentally, three of the patients were functioning in the normal range and one was mildly retarded. However, gross motor skills were delayed in all patients. Although infants with end-stage renal disease are usually severely growth retarded and developmentally delayed, our observations suggest that early nutritional intervention and dialysis can yield improved results.

Blood Urea Nitrogen↗