Related Experiment Video
Updated: Apr 16, 2026
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
Growth impairment in children with pre-dialysis chronic kidney disease in Japan
Yuko Hamasaki1, Kenji Ishikura2,3, Osamu Uemura4
1Department of Pediatric Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. yuhamasaki@med.toho-u.ac.jp.
Insights
Growth impairment is common in Japanese children with chronic kidney disease (CKD). Advanced CKD stages, being small-for-date, and birth asphyxia are key risk factors for poor growth in these pediatric patients.
Area of Science:
- Pediatric Nephrology
- Growth and Development
- Chronic Kidney Disease Research
Background:
- Growth impairment is a significant complication in pediatric chronic kidney disease (CKD).
- Limited cohort data exists on the growth patterns of Asian children with pre-dialysis CKD.
Purpose of the Study:
- To investigate growth patterns in Japanese children with pre-dialysis CKD stages 3-5.
- To identify risk factors associated with growth impairment in this population.
Main Methods:
- A cross-sectional survey was distributed to 113 Japanese medical institutions.
- Data on height and CKD stage were collected for 297 children with CKD stages 3-5 from 2010-2011.
- Height standard deviation score (SDS) was calculated to assess growth status.
Main Results:
- Height SDS significantly decreased with advancing CKD stage in both boys and girls (P < 0.001).
- Congenital anomalies of the kidney and urinary tract were associated with decreased height SDS (P < 0.001).
- Risk factors for growth impairment included advanced CKD stages (4-5), being small-for-date, and birth asphyxia.
Conclusions:
- Japanese children with CKD stages 3-5 exhibit significant growth impairment compared to healthy peers.
- Advanced CKD, being small-for-date, and birth asphyxia are identified as key risk factors.
- Growth hormone therapy was infrequently utilized in children with pre-dialysis CKD.
Background:
Growth impairment is a major complication of chronic kidney disease (CKD) in children. However, no cohort studies have examined the growth of Asian children with pre-dialysis CKD.
Methods:
We sent cross-sectional surveys to 113 Japanese medical institutions that were treating 447 children with CKD stages 3-5 in 2010 and 2011. Of 447 children included in our survey conducted in 2010, height and CKD stage were evaluable for 297 children in 2011, and height standard deviation score (height SDS) was calculated in these children.
Results:
Height SDS decreased with increasing CKD stage (P < 0.001) in boys and girls. Height SDS also decreased significantly with increasing CKD stage among patients with congenital anomalies of the kidney and urinary tract (P < 0.001). Risk factors for growth impairment included CKD stages 4 and 5 (relative to stage 3), being small-for-date, and asphyxia at birth. Among children with a height SDS ≤-2.0, growth hormone was used in 19.5, 31.0, and 25.0 % of children with CKD stages 3, 4, and 5, respectively.
Conclusions:
This prospective cohort study revealed marked growth impairment in Japanese children with CKD stages 3-5 relative to healthy children. CKD-related risk factors for growth impairment included advanced CKD (stages 4 and 5), being small-for-date, and asphyxia at birth. Growth hormone was infrequently used in this cohort of children with pre-dialysis CKD.
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:25Chronic Kidney Disease I: Introduction
01:28Chronic Kidney Disease III: Interprofessional Care
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:18Chronic Kidney Disease IV: Nursing Management
01:29Acute Kidney Injury III: Clinical Manifestations