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Single-Center Experience on Growth in Infants Born With End-Stage Kidney Disease

Cara L Slagle1, Stefanie L Riddle2, Kera McNelis2

  • 1Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Nephrology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation
|September 30, 2022
PubMed

Insights

Infants with severe congenital anomalies of the kidney and urinary tract (CAKUT) requiring dialysis show significant growth disruption in early life. While dialysis improved growth compared to non-dialysis CAKUT infants, linear growth did not normalize by one year.

Area of Science:

  • Pediatric Nephrology
  • Developmental Biology
  • Clinical Nutrition

Background:

  • Chronic kidney disease (CKD) in children is associated with poor growth, affecting health outcomes.
  • Data on growth patterns in infants with severe congenital anomalies of the kidney and urinary tract (CAKUT) are limited.
  • Severe CAKUT often necessitates early medical intervention, including dialysis.

Purpose of the Study:

  • To examine the growth patterns of infants diagnosed with severe CAKUT who require dialysis within the first 30 days of life.
  • To understand the impact of early dialysis on somatic growth in this vulnerable population.

Main Methods:

  • A cohort study evaluated infants with severe CAKUT from 2014 to 2018 who survived past 30 days.
  • Somatic growth parameters were assessed against standard infant growth curves.
  • Nutritional information was systematically recorded for all participants.

Main Results:

  • Twenty-four infants met the inclusion criteria; 17 required dialysis.
  • Somatic growth disruption was most pronounced between 1-2 months postnatal age in infants receiving dialysis.
  • While growth trends improved compared to CAKUT infants not requiring dialysis, linear growth remained subnormal by 1 year of age.

Conclusions:

  • Infants with severe CAKUT face a high risk of early growth failure.
  • Early dialysis may influence growth trajectories, but long-term normalization is not achieved by one year.
  • Further research is needed to develop targeted nutritional strategies to address growth deficits in infants with CAKUT.
Abstract

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