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Head circumference in chronic renal failure from birth
1Department of Pediatrics, University Hospital Gasthuisberg, Leuven, Belgium.
Insights
Children with chronic renal failure from birth experience poor growth. Recombinant human growth hormone (rhGH) treatment significantly improved head circumference and height in these pediatric patients.
Area of Science:
- Pediatric Nephrology
- Developmental Biology
- Endocrinology
Background:
- Chronic renal failure (CRF) in childhood significantly impacts growth and development.
- Limited data exists on head circumference growth in infants with congenital CRF.
Purpose of the Study:
- To analyze growth patterns, including head circumference, in children with CRF from birth.
- To evaluate the effect of recombinant human growth hormone (rhGH) on growth parameters.
Main Methods:
- A cohort of 19 children with CRF from birth was monitored until age 5.
- Analyzed variables included body height, body mass index, and head circumference (SDS).
- Eight patients received rhGH treatment after 2 years of age.
Main Results:
- A significant drop in height, BMI, and head circumference SDS occurred within the first 3 months.
- Stable growth velocity was observed post-3 months, with BMI improving after 36 months.
- rhGH treatment led to significant increases in height and head circumference SDS.
Conclusions:
- Head circumference growth parallels body height growth in young children with CRF.
- This correlation holds true before and during rhGH treatment.
- rhGH therapy demonstrates a positive impact on both linear and cranial growth in this cohort.
Aims:
Chronic renal failure in childhood jeopardizes both growth and development. In children with chronic renal failure from birth, growth in height and weight have been found to be generally poor. Few data on head circumference are available.
Material:
A cohort of 19 children with chronic renal failure from birth was studied from the early weeks of life to the age of 5 years. There were 18 boys; and 18 patients had congenital renal hypoplasia or hypodysplasia associated with obstructive uropathies. Eight patients received recombinant growth hormone (rhGH) after the age of 2 years. Only 2 patients needed renal replacement therapy before the age of 5 years. Data after transplantation were not included.
Methods:
The following variables were analyzed: body height, body mass index and head circumference. Data were expressed in median values of standard deviations scores (SDS).
Results:
In the first 3 months of life there was a significant drop in height SDS, body mass index SDS and head circumference SDS. Thereafter, a stable growth velocity was observed for the rest of the study period, except for body mass index SDS. which improved after 36 months. There was a striking difference between patients who needed treatment or not with recombinant human growth hormone (rhGH). Patients without rhGH displayed a stable growth after the age of 3 months until 5 years of age. In the remaining 8 patients, rhGH treatment resulted in a significant increase not only in height SDS but also in head circumference SDS.
Conclusions:
In infants and young children with chronic renal failure from birth, growth in head circumference parallels growth in body height. This applies to all patients and to data before and during rhGH treatment.
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