The role and relevance of nutritional diagnosis in pediatric oncology

Le résumé fourni par la source

In the Russian Federation the incidence of cancer remains high. Depending on the nosology of the tumor, the probability of malnutrition during primary hospitalization may be 10-50%, and during treatment it may reach 100%. Undernutrition and obesity are independent factors of poor prognosis, reducing the overall effectiveness of treatment. At the same time, the diagnosis of nutritional status (NS) in pediatric oncology is not clearly regulated, which, in the presence of a large number of factors affecting the functioning of the digestive, nervous, endocrine and other systems, creates prerequisites for untimely recognition of nutritional disorders and, accordingly, inadequate nutritional support. Taking into account the mentioned tendencies above it is of great value to establish the foundations for recommendations on the assessment of NS and for making nutritional diagnosis in pediatric oncology. In order to highlight and resolve this challenge the interpretation of clinical aspects, advantages and disadvantages of existing screening scales for NS assessing, anthropometric indicators, methods for body composition evaluation, eating disorders classification according to the World Health Organization, the International Classification of Diseases 10 revision and specialized medical associations was carried out. Based on modern convictions regarding the pathogenesis of protein-energy malnutrition and cachexia, side effects and complications of antitumor treatment, available tools for assessing NS, their systematization, a unified nutritional diagnosis structure was formed. It includes: NS screening, nutritional history, anthropometry dynamics, evaluation of the gastrointestinal tract state and the presence of metabolic disorders, alimentation level, determination of nutritional risk factors. NS is a complex indicator and its reflection can be a nutritional diagnosis, which will potentially allow determining the current NS state, predicting the risks of malnutrition developing, implementing rational nutritional support, and thus improving the effectiveness of cancer treatment.

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