{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:47:23Z","timestamp":1790369243300,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Long-term parenteral nutrition (PN) has been associated with renal complications, including hypercalciuria, nephrocalcinosis, proteinuria and reduced glomerular filtration rate (GFR). Pediatric data are scarce and mostly short-term. Our study aimed to evaluate renal complications in children with intestinal failure (IF) receiving long-term PN. Methods: A cross-sectional study was performed in a tertiary pediatric IF clinic of patients receiving home-PN treatment for more than 1 year. Data regarding medical background, anthropometrics, laboratory investigations and abdominal sonography were retrieved. Results: Complete data were available for 15 children (67% males), with a median age of 6 (range 1.5\u201315) years and a median (IQR) PN duration of 4 (1.5\u20136) years. Low-grade proteinuria was identified in 61% and microalbuminuria in 30% of the cohort. Hypercalciuria and hyperoxaluria were present in 50% and 46%, respectively. One patient had nephrocalcinosis. The estimated GFR was normal in all but one patient who had pre-existing kidney disease. Conclusions: Pediatric IF patients can present with preserved kidney function after years of PN treatment. Despite the high prevalence of hypercalciuria, nephrocalcinosis was not common. Base line and long-term monitoring of various aspects of renal function would be essential to characterize the effects of prolonged PN on kidney functions in pediatric patients.<\/jats:p>","DOI":"10.3390\/nu13103647","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T03:01:13Z","timestamp":1634698873000},"page":"3647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Children with Intestinal Failure Maintain Their Renal Function on Long-Term Parenteral Nutrition"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4175-7432","authenticated-orcid":false,"given":"Anat","family":"Guz Mark","sequence":"first","affiliation":[{"name":"Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelly","family":"Levi","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel"},{"name":"Institute of Pediatric Nephrology, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Davidovits","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel"},{"name":"Institute of Pediatric Nephrology, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luba","family":"Marderfeld","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"},{"name":"Nutrition and Dietetics Department, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4287-3681","authenticated-orcid":false,"given":"Raanan","family":"Shamir","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.clnu.2014.08.017","article-title":"ESPEN endorsed recommendations. Definition and classification of intestinal failure in adults","volume":"34","author":"Pironi","year":"2015","journal-title":"Clin. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1097\/MPG.0000000000001722","article-title":"Intestinal Rehabilitation Programs in the Management of Pediatric Intestinal Failure and Short Bowel Syndrome","volume":"65","author":"Merritt","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1053\/j.gastro.2005.12.002","article-title":"Causes and management of intestinal failure in children","volume":"130","author":"Goulet","year":"2006","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1016\/j.clnu.2018.06.956","article-title":"ESPGHAN\/ESPEN\/ESPR\/CSPEN guidelines on pediatric parenteral nutrition: Complications","volume":"37","author":"Hartman","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.1016\/j.clnu.2018.06.954","article-title":"ESPGHAN\/ESPEN\/ESPR\/CSPEN guidelines on pediatric parenteral nutrition: Home parenteral nutrition","volume":"37","author":"Hill","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1177\/0148607100024004234","article-title":"Renal function and urinary excretion of electrolytes in patients receiving cyclic parenteral nutrition","volume":"24","author":"Robert","year":"2000","journal-title":"JPEN"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.nut.2014.02.001","article-title":"Renal function in patients on long-term home parenteral nutrition and in intestinal transplant recipients","volume":"30","author":"Pironi","year":"2014","journal-title":"Nutrition"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/S0022-3476(05)83034-3","article-title":"Renal function of children receiving long-term parenteral nutrition","volume":"119","author":"Moukarzel","year":"1991","journal-title":"J. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.jpedsurg.2016.02.025","article-title":"Prevalence of renal abnormality in pediatric intestinal failure","volume":"51","author":"Kosar","year":"2016","journal-title":"J. Pediatr. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1097\/MPG.0000000000001814","article-title":"High Incidence of Proteinuria in Children with Chronic Intestinal Failure Under Long-term Parenteral Nutrition","volume":"66","author":"Billing","year":"2018","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1097\/MPG.0000000000002873","article-title":"Nephrocalcinosis and Renal Dysfunction in Pediatric Intestinal Failure","volume":"71","author":"Roberts","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1053\/j.sempedsurg.2017.09.006","article-title":"Long-term outcomes of pediatric intestinal failure","volume":"26","author":"Fullerton","year":"2017","journal-title":"Semin. Pediatr. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1002\/jgh3.12123","article-title":"Monitoring of long-term parenteral nutrition in children with intestinal failure","volume":"3","author":"Zemrani","year":"2019","journal-title":"JGH Open"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e20171904","DOI":"10.1542\/peds.2017-1904","article-title":"Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents","volume":"140","author":"Flynn","year":"2017","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1681\/ASN.2008030287","article-title":"New equations to estimate GFR in children with CKD","volume":"20","author":"Schwartz","year":"2009","journal-title":"JASN"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/BF00442743","article-title":"Reference values for urinary calcium excretion and screening for hypercalciuria in children and adolescents","volume":"143","author":"Kruse","year":"1984","journal-title":"Eur. J. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/S0022-3476(84)80478-3","article-title":"Assessment of proteinuria using random urine samples","volume":"104","author":"Houser","year":"1984","journal-title":"J. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Yang, C.Y., Chen, F.A., Chen, C.F., Liu, W.S., Shih, C.J., Ou, S.M., Yang, W.C., Lin, C.C., and Yang, A.H. (2015). Diagnostic Accuracy of Urine Protein\/Creatinine Ratio Is Influenced by Urine Concentration. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0137460"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/BF00866297","article-title":"Population based data on urinary excretion of calcium, magnesium, oxalate, phosphate and uric acid in children from Cimitile (southern Italy)","volume":"6","author":"Capasso","year":"1992","journal-title":"Pediatr. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s00467-019-04405-5","article-title":"Correlation of urine protein\/creatinine ratios to 24-h urinary protein for quantitating proteinuria in children","volume":"35","author":"Huang","year":"2020","journal-title":"Pediatr. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"924","DOI":"10.2337\/diacare.29.04.06.dc06-1555","article-title":"Albumin-to-creatinine ratio in random urine samples might replace 24-h urine collections in screening for micro- and macroalbuminuria in pregnant woman with type 1 diabetes","volume":"29","author":"Justesen","year":"2006","journal-title":"Diabetes Care"},{"key":"ref_22","first-page":"1","article-title":"KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"3","author":"Eknoyan","year":"2013","journal-title":"Kidney Int. Suppl."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.nut.2017.07.011","article-title":"Intestinal failure as a significant risk factor for renal impairment in children","volume":"45","author":"Ylinen","year":"2018","journal-title":"Nutrition"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"137","DOI":"10.3389\/fped.2019.00137","article-title":"Renal Function in Children on Long Term Home Parenteral Nutrition","volume":"7","author":"Messova","year":"2019","journal-title":"Front. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"348","DOI":"10.2215\/CJN.02870707","article-title":"Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C","volume":"3","author":"Baxmann","year":"2008","journal-title":"CJASN"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.nut.2018.10.005","article-title":"Outcome of kidney function in adults on long-term home parenteral nutrition for chronic intestinal failure","volume":"60","author":"Agostini","year":"2019","journal-title":"Nutrition"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.clnu.2005.09.010","article-title":"Chronic dehydration may impair renal function in patients with chronic intestinal failure on long-term parenteral nutrition","volume":"25","author":"Lauverjat","year":"2006","journal-title":"Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1093\/ndt\/gft035","article-title":"Aldosterone and the kidney: A rapidly moving frontier (an update)","volume":"29","author":"Ritz","year":"2014","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1056\/NEJM198209093071104","article-title":"Dietary protein intake and the progressive nature of kidney disease: The role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease","volume":"307","author":"Brenner","year":"1982","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/1743-7075-2-25","article-title":"Dietary protein intake and renal function","volume":"2","author":"Martin","year":"2005","journal-title":"Nutr. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1038\/ki.1992.406","article-title":"Influence of the level of hydration on the renal response to a protein meal","volume":"42","author":"Bankir","year":"1992","journal-title":"Kidney Int."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/s00467-013-2469-9","article-title":"Renal consequences of parenteral nutrition","volume":"29","author":"Dudley","year":"2014","journal-title":"Pediatr. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/ncp.10113","article-title":"Bacteria, Bones, and Stones: Managing Complications of Short Bowel Syndrome","volume":"33","author":"Johnson","year":"2018","journal-title":"Nutr. Clin. Pract."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"530","DOI":"10.7326\/0003-4819-100-4-530","article-title":"Hyperoxaluria and renal insufficiency due to ascorbic acid administration during total parenteral nutrition","volume":"100","author":"Swartz","year":"1984","journal-title":"Ann. Int. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1080\/07315724.1995.10718469","article-title":"Excessive urinary oxalate excretion occurs in long-term TPN patients both with and without ileostomies","volume":"14","author":"Buchman","year":"1995","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1210\/jcem-55-6-1052","article-title":"Hypocitraturia in calcium nephrolithiasis","volume":"55","author":"Rudman","year":"1982","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/10\/3647\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:17:34Z","timestamp":1760167054000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/10\/3647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,18]]},"references-count":36,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["nu13103647"],"URL":"https:\/\/doi.org\/10.3390\/nu13103647","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,18]]}}}