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Growth and maturation improvement in children on renal replacement therapy over the past 20 years

Doris Franke1, Stella Winkel, Jutta Gellermann

  • 1Department of Paediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.

Pediatric Nephrology (Berlin, Germany)
|May 28, 2013
PubMed

Insights

Growth and maturation in children on renal replacement therapy (RRT) have significantly improved over two decades. Recent German RRT patients show better height, pubertal development, and BMI compared to earlier cohorts.

Area of Science:

  • Pediatric Nephrology
  • Growth and Development
  • Renal Replacement Therapy

Background:

  • Normal growth and maturation are significant challenges for children and adolescents undergoing renal replacement therapy (RRT).
  • Previous studies highlight difficulties in achieving optimal growth outcomes in this pediatric population.

Purpose of the Study:

  • To compare growth and maturation in German children on RRT between 1998-2009 with historical data from the European Dialysis and Transplant Association (EDTA) Registry (1985-1988).
  • To assess improvements in growth parameters and pubertal development over a 20-year period in pediatric RRT patients.

Main Methods:

  • Retrospective analysis comparing 384 German children on RRT (1998-2009) with 732 children from the EDTA Registry (1985-1988).
  • Data included transplant rates, height standard deviation score (SDS), pubertal growth spurt, age at menarche, bone maturation, and body mass index (BMI).

Main Results:

  • Mean height SDS improved significantly from -3.03 to -1.80 over 20 years (p < 0.001).
  • Adolescent height SDS showed marked improvement (-3.40 vs. -1.52; p < 0.001).
  • Significant advancements were observed in pubertal delay, menarche timing, bone maturation, and BMI in the recent cohort.

Conclusions:

  • Paediatric patients on RRT have experienced substantial improvements in growth and maturation over the past two decades.
  • These findings indicate progress in managing growth and development in children with kidney disease requiring RRT.
Abstract

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