The effects of resins added to the milk of children suffering from chronic kidney disease: a clinical relevance to control potassium and phosphate levels? (notice n° 1365617)
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| fixed length control field | 06084cam a2200349 4500500 |
| 005 - DATE AND TIME OF LATEST TRANSACTION | |
| control field | 20250511000258.0 |
| 041 ## - LANGUAGE CODE | |
| Language code of text/sound track or separate title | fre |
| 042 ## - AUTHENTICATION CODE | |
| Authentication code | dc |
| 100 10 - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Bechara, Rouba |
| Relator term | author |
| 245 00 - TITLE STATEMENT | |
| Title | The effects of resins added to the milk of children suffering from chronic kidney disease: a clinical relevance to control potassium and phosphate levels? |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Date of publication, distribution, etc. | 2025.<br/> |
| 500 ## - GENERAL NOTE | |
| General note | 5 |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Background. In infants with chronic kidney disease (CKD), the management of nutrition and growth is highly challenging, particularly compared to older children. Management of hyperkalemia and hyperphosphatemia is difficult, and incorporating potassium and phosphate binders directly in formulas could be beneficial, as it avoids direct ingestion of resins by infants. Materials and methods. We conducted a study using Gallia® standard first-stage infant formula and Pregestimil®. We added either carbonate sevelamer (Renvela®, 200, 400 or 800 mg) or polystyrene sulfonate (Resikali®, 2000, 4000 or 8000 mg) to 90 ml of formula. Additionally, we evaluated the combined use of the resins with Gallia® by adding in 90 mL 200 mg/2000 mg, 400 mg/4000 mg, and 200 mg/4000 mg of Renvela® and Resikali®, respectively. The Milk was decanted for 10 minutes, and the resulting supernatants were weighted and analyzed for osmolality and pH. Sodium, potassium, chlore, bicarbonate, magnesium, glucose, calcium, phosphate, protein, cholesterol, triglycerides, iron, folate, vitamin B12 levels were measured after centrifugation. Results. With polystyrene sulfonate, potassium levels in milk decreased in a dose-dependent manner, by 36%, 52% and 68%, respectively. Polystyrene sulfonate also reduced magnesium levels and increased both calcium concentration (from 9.7 to 21 mmol/L) and osmolality (from 359 to 423 mOsm/kg). No significant effect on phosphate was observed. Sevelamer decreased both calcium and phosphate concentrations in a dose-dependent manner, by 14%, 26% and 29%, and by 24%, 36% and 40%, respectively. Sevelamer also increased pH from 6.9 to 9.1, and decreased folate levels by 32%, 66% and 81% respectively, from 465 to 88 mmol/L. The combined use of sevelamer and polystyrene sulfonate results in decreased levels of potassium (by 45%, 59% and 59%, respectively), phosphate (by 38%, 39% and 36%, respectively), and folate, albeit with a slighter increase in pH. Osmolality remained unchanged and no other relevant differences were observed. Conclusion. Pretreating formulas with resins is a reproducible and straightforward method when specific diets for CKD are unavailable. However, it is important to keep in mind that resins may impact the overall composition (osmolality) and the concentration of other nutrients (folates). |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Contexte. Chez les nourrissons atteints d’insuffisance rénale chronique (IRC), la gestion de la nutrition et de la croissance est particulièrement complexe, bien plus que chez les enfants plus âgés. Le contrôle de l’hyperkaliémie et de l’hyperphosphatémie représente un véritable défi. L’ajout direct de chélateurs du potassium et du phosphate dans les biberons de lait pourrait présenter un avantage, en évitant l’administration directe de résines aux nourrissons. Matériels et méthodes. Nous avons réalisé une étude à partir de deux préparations infantiles de premier âge : Gallia® et Pregestimil®. Du carbonate de sevelamer (Renvela® – 200, 400 ou 800 mg) ou du polystyrène sulfonate (Resikali® – 2000, 4000 ou 8000 mg) ont été ajoutés à 90 mL de lait infantile. Des combinaisons des deux résines ont également été testées avec Gallia® : 200 mg/2 000 mg, 400 mg/4 000 mg, et 200 mg/4 000 mg de Renvela®/Resikali®, respectivement. Après dix minutes de décantation, les surnageants ont été prélevés, pesés, puis analysés pour leur osmolalité et leur pH. Les concentrations de divers éléments ont été mesurées après centrifugation : sodium, potassium, chlorure, bicarbonate, magnésium, glucose, calcium, phosphate, protéines, cholestérol, triglycérides, fer, folates et vitamine B12. Résultats. Le polystyrène sulfonate a induit une réduction dose-dépendante du potassium (36 %, 52 %, et 68 %), tout en diminuant le magnésium et en augmentant le calcium (de 9,7 à 21 mmol/L) ainsi que l’osmolalité (de 359 à 423 mOsm/kg). Aucun effet notable sur le phosphate n’a été observé. Le sevelamer, quant à lui, a réduit les concentrations de calcium (14 %, 26 %, et 29 %) et de phosphate (24 %, 36 %, et 40 %) de manière dose-dépendante. Il a également augmenté le pH (de 6,9 à 9,1) et diminué significativement les taux de folates (32 %, 66 %, et 81 %, soit de 465 à 88 mmol/L). L’association des deux résines a entraîné une diminution des taux de potassium (45 %, 59 %, et 59 %), de phosphate (38 %, 39 %, et 36 %) et de folates, accompagnée d’une légère hausse du pH. L’osmolalité est restée stable, sans autre variation significative. Conclusion. Le prétraitement des laits infantiles à l’aide de résines constitue une méthode simple, reproductible et pertinente en l’absence de préparations adaptées aux nourrissons souffrant d’IRC. Néanmoins, il convient de rester vigilant quant aux effets potentiels sur l’osmolalité et sur la teneur en nutriments essentiels, tels que les folates. |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | CKD-MBD |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | maladie rénale chronique |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | nutrition |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | pédiatrie |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | traitement |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | chronic kidney disease |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | CKD-MBD |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | nutrition |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | pediatric |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | treatment |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Chambon, Véronique |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Naud, Corentin |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Ranchin, Bruno |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | De Mul, Aurélie |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Bacchetta, Justine |
| Relator term | author |
| 786 0# - DATA SOURCE ENTRY | |
| Note | Néphrologie & Thérapeutique | Volume 21 | 2 | 2025-05-07 | p. 96-103 | 1769-7255 |
| 856 41 - ELECTRONIC LOCATION AND ACCESS | |
| Uniform Resource Identifier | <a href="https://shs.cairn.info/revue-nephrologie-et-therapeutique-2025-2-page-96?lang=fr&redirect-ssocas=7080">https://shs.cairn.info/revue-nephrologie-et-therapeutique-2025-2-page-96?lang=fr&redirect-ssocas=7080</a> |
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