ESPN 50th Annual Meeting

ESPN 2017

Obtaining Growth data using hospital information systems

1- University Hospital Southampton
2- University of Southampton

CKD is associated with significant morbidity, and mortality. A poor nutritional state can adversely affect its progression, and be reflected in anthropometric measures. Such measurements are poorly characterised outside those with the most severe disease, despite data being recorded and essential to identifying early changes to improve clinical outcome.

The aim was to explore the feasibility of producing a report on the prevalence of under and over nutrition in children with CKD. The objectives to use the electronic systems to obtain data and explore relationships with kidney function.




Material and methods:

Children were identified using clinic codes. The first appointment recorded for weight, height, BMI and creatinine was used. Data was electronically transferred onto a specifically designed database and used to generate z scores and estimated glomerular filtration rate (eGFR). The prevalence of under and over nutrition was estimated, and the relationship with kidney function explored. 


819 children were included. Weight and height were lower in the end stage programme (CKD stage 4-5) compared to general nephrology clinics (CKD2-3) (p=<0.001). Stunting was more pronounced in the transplant clinics, and under-nutrition in the low clearance clinic. Stunting, under-nutrition and over-nutrition were  found across all clinics.

As the severity of disease worsened, weight and height decreased (p=<0.001) adjusted for age and group. The younger children had lower weight and height sds (p=<0.001).




Poor nutrition (under and over) starts early in disease and becomes worse as disease progresses.

Electronic systems can be used to identify those at risk from poor nutritional status and to characterize a clinical population, and provide larger cohorts have manual reviews. The ability to access this data annually has the potential to be a powerful tool to early identification of those that may not be thought to be at risk and to target preventative clinical care as well as end stage disease.