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Growth in chronic kidney disease

Halima S Janjua1, John D Mahan

  • 1Division of Nephrology, Department of Pediatrics, Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, 43205, USA.

Advances in Chronic Kidney Disease
|September 8, 2011
PubMed

Insights

Children with chronic kidney disease (CKD) often experience poor growth due to growth hormone (GH) resistance. Recombinant GH (rGH) therapy can improve growth velocity in these children.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth Disorders

Background:

  • Poor growth is a common and serious complication of chronic kidney disease (CKD) in children, impacting psychosocial development and adult health.
  • Growth failure in CKD has multifactorial causes, including disruptions in the growth hormone (GH) and insulin-like growth factor-1 (IGF-1) axis.
  • CKD is characterized by GH resistance, not GH deficiency, with several underlying mechanisms contributing to this resistance.

Purpose of the Study:

  • To review the pathogenesis of growth failure in children with CKD.
  • To discuss the effects of growth failure on children's development.
  • To explore management strategies for growth failure in pediatric CKD patients.

Main Methods:

  • Review of existing literature on growth failure in pediatric CKD.
  • Analysis of the role of GH/IGF-1 axis dysfunction.
  • Evaluation of recombinant GH (rGH) therapy efficacy and safety.

Main Results:

  • Disordered GH and IGF-1 axis function are key contributors to poor growth in pediatric CKD.
  • Recombinant GH (rGH) therapy is an effective and safe option to accelerate growth velocity in children with CKD.
  • Despite proven benefits, rGH therapy is underutilized in this population due to practitioner and family hesitancy.

Conclusions:

  • Growth failure in children with CKD is a complex issue requiring targeted management strategies.
  • Understanding GH resistance is crucial for addressing poor growth in pediatric CKD.
  • Increased awareness and acceptance of rGH therapy could improve growth outcomes for children with CKD.

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