Assessment of body composition in children with chronic renal failure

In children with chronic renal failure treated conservatively by dialysis o r by transplantation, various alterations of the nutritional, metabolic and fluid homeostasis may occur that may critically affect the patients' acute and chronic well-being. In the past, the assessment of body composition in children was hampered by insufficient precision, standardization and/or av ailability of appropriate anthropometric tools. Recently, there have been s everal methodological advances that may facilitate close and precise monito ring of body composition in this population. Specifically, the use of body mass index (BMI) data in children has become possible by the introduction o f pediatric reference values processed for the calculation of standard devi ation scores accounting for the skewed distribution of BMI. Skewness adapte d reference data have also been provided for percentage fat mass as assesse d by multisite skinfold measurements. In addition, bioelectrical impedance analysis has been validated in healthy children as well as in pediatric dia lysis and renal transplant populations. This novel auxological technique pr ovides a highly reproducible, non-invasive and inexpensive way of assessing changes in total body water content in dialysed patients, as well as chang es in fat and fat-free mass prior to dialysis and after renal transplantati on.