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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

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Assessment and treatment of short stature in pediatric patients with chronic kidney disease: a consensus statement

John D Mahan1, Bradley A Warady,

  • 1Department of Pediatrics, Division of Pediatric Nephrology, The Ohio State University COMPH, Columbus, OH, USA. MahanJ@pediatrics.ohio-state.edu

Pediatric Nephrology (Berlin, Germany)
|June 15, 2006
PubMed

Insights

Children with chronic kidney disease (CKD) often experience growth failure due to various factors. This review offers an evidence-based algorithm to guide assessment and treatment for improved growth outcomes.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth Disorders

Background:

  • Growth failure is a significant complication in pediatric chronic kidney disease (CKD), impacting morbidity and mortality.
  • Impaired growth in children with CKD stems from multifactorial causes including the growth hormone (GH)-insulin-like growth factor-I (IGF-I) axis dysfunction, malnutrition, acidosis, and renal bone disease.
  • Management challenges are compounded by comorbidities and reluctance towards GH therapy due to injection burden, cost, or transplantation.

Purpose of the Study:

  • To review the multifaceted issue of growth failure in children with chronic kidney disease (CKD).
  • To highlight the contributing factors and management complexities associated with impaired growth in this population.
  • To present a consensus-driven algorithm for the assessment and treatment of growth failure in pediatric CKD.

Main Methods:

  • Literature review on growth failure in pediatric CKD.
  • Analysis of factors contributing to impaired growth.
  • Development of a clinical algorithm by a consensus committee.

Main Results:

  • Growth failure is multifactorial in pediatric CKD, involving hormonal, nutritional, and metabolic derangements.
  • GH therapy has demonstrated efficacy and safety, yet adoption is hindered by practical and logistical concerns.
  • A consensus algorithm provides a structured approach to optimize growth and health outcomes.

Conclusions:

  • Addressing growth failure in pediatric CKD requires a comprehensive strategy.
  • The developed algorithm aims to guide clinicians in the effective assessment and management of growth issues.
  • Improved management of growth failure can lead to better overall health outcomes for children with CKD.

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