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Does growth retardation indicate suboptimal clinical care in children with chronic renal disease and those undergoing

S L Furth1, D C Alexander, A M Neu

  • 1Department of Pediatrics, The Johns Hopkins Medical Institutions, Baltimore, MD, USA. sfurth@jhmi.edu

Seminars in Nephrology
|September 18, 2001
PubMed

Insights

Growth failure is a significant issue for children with end-stage renal disease (ESRD), impacting their quality of life and potentially indicating higher health risks. Current management strategies show variability, highlighting the need for optimized care guidelines.

Area of Science:

  • Pediatric Nephrology
  • Growth and Development
  • Chronic Kidney Disease Management

Background:

  • Growth failure is a critical concern for pediatric patients with end-stage renal disease (ESRD).
  • Poor final adult height and associated adverse clinical outcomes, including increased hospitalizations and mortality, are linked to growth retardation in children with ESRD.
  • Growth failure may serve as a marker for high-risk patient groups rather than a direct cause of morbidity.

Purpose of the Study:

  • To review the prevalence of growth retardation in US children with chronic renal disease.
  • To present recent data on the morbidity associated with growth failure in this population.
  • To evaluate existing strategies for optimizing growth in children with ESRD and discuss the need for improved management guidelines.

Main Methods:

  • Systematic review of published literature on growth retardation in pediatric ESRD.
  • Analysis of recent data on clinical outcomes and morbidity associated with poor growth.
  • Discussion of current clinical management practices and the development of practice guidelines.

Main Results:

  • Growth retardation is prevalent in children with chronic renal disease in the US.
  • Growth failure is associated with increased hospitalizations and mortality, suggesting it as a marker for high-risk patients.
  • Despite aggressive management, a subset of children with long-term renal insufficiency and ESRD continue to experience poor linear growth.

Conclusions:

  • Optimizing growth in children with ESRD remains challenging, even with vigilant clinical management.
  • There is significant variability in the current management of growth retardation in pediatric ESRD.
  • Developing and implementing evidence-based practice guidelines is crucial to optimize growth and improve outcomes for children with ESRD.

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