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Strategies for Optimizing Growth in Children With Chronic Kidney Disease

Dieter Haffner1

  • 1Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School Children's Hospital, Hanover, Germany.

Frontiers in Pediatrics
|August 28, 2020
PubMed

Insights

Growth failure in children with chronic kidney disease (CKD) requires early diagnosis and management. Prompt intervention, including nutritional support and medical therapies, is crucial for optimal outcomes.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth and Development

Background:

  • Growth failure is a significant complication in children with chronic kidney disease (CKD).
  • Early detection and management are critical due to the increased risk of severe growth retardation in younger children.
  • Growth issues in pediatric CKD impact patients' and families' psychosocial well-being.

Purpose of the Study:

  • To review current guidelines for preventing and treating growth failure in pediatric chronic kidney disease.
  • To emphasize the importance of early intervention before dialysis initiation.
  • To discuss comprehensive management strategies for growth disorders in children with CKD.

Main Methods:

  • Review of recent guidelines and literature on growth failure in pediatric chronic kidney disease.
  • Discussion of multi-faceted therapeutic interventions.
  • Focus on strategies applicable across all ages and stages of kidney disease.

Main Results:

  • Effective management involves preserving renal function, ensuring adequate nutrition, and correcting metabolic/endocrine abnormalities.
  • Therapeutic interventions include renin-angiotensin aldosterone system inhibitors, nutritional support, electrolyte/acidosis correction, and parathyroid hormone control.
  • Recombinant human growth hormone and early kidney transplantation are key for persistent issues and end-stage disease.

Conclusions:

  • A comprehensive, multidisciplinary approach is essential for managing growth failure in children with CKD.
  • Early and proactive interventions significantly improve growth outcomes and psychosocial integration.
  • Adherence to updated guidelines ensures optimal care for pediatric CKD patients experiencing growth impairment.

Keywords:
CKD-MBDchildrenchronic kidney diseasegrowthgrowth hormonenutrition

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