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Height at First RRT and Mortality in Children.

Elaine Ku1,2, Richard N Fine3, Chi-Yuan Hsu1

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Clinical Journal of the American Society of Nephrology : CJASN
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PubMed
Summary
This summary is machine-generated.

Children with short or tall stature face increased mortality risk after starting renal replacement therapy (RRT). This risk is influenced by body mass index, with tall stature posing a higher risk in obese children.

Keywords:
body heightbody mass indexchildfollow-up studiesgrowth failureheighthumanspediatric ESRDrenal dialysisrenal replacement therapy

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Area of Science:

  • Pediatric Nephrology
  • Clinical Epidemiology
  • Biostatistics

Background:

  • Poor linear growth is common in pediatric chronic kidney disease (CKD) and linked to higher mortality.
  • Adult dialysis patients with tall stature show increased mortality risk.
  • The impact of extreme height on mortality in children starting renal replacement therapy (RRT) requires investigation.

Purpose of the Study:

  • To investigate the association between short or tall stature and all-cause mortality in children initiating RRT.
  • To examine cause-specific mortality risks in children with extreme heights.
  • To explore potential modifying effects of body mass index (BMI) on height-related mortality risk.

Main Methods:

  • Retrospective analysis of 13,218 children (aged 2-19 years) from the US Renal Data System (1995-2011).
  • Children received their first RRT (dialysis or transplant).
  • Adjusted Cox models assessed the association between height percentiles (<3rd and >3rd) and mortality risk.

Main Results:

  • Increased mortality risk observed in both short stature (HR, 1.49) and tall stature (HR, 1.32) children.
  • A significant interaction between height and BMI (P=0.04) indicated that tall stature's mortality risk was primarily in children with elevated BMI (≥95th percentile).
  • Short stature linked to higher cardiac and infection-related deaths; tall stature linked to higher cancer-related deaths.

Conclusions:

  • Both short and tall stature are associated with increased mortality risk in children initiating RRT.
  • Body mass index modifies the association between tall stature and mortality.
  • Further research is needed to elucidate the mechanisms underlying heightened mortality risk in children with extreme heights.