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Statural growth of children with renal disease
Insights
Growth failure affects many children with kidney disease, including those with congenital or acquired conditions. Treatments like prednisone and dialysis can also hinder growth, alongside factors like azotemia and acidosis.
Area of Science:
- Pediatric Nephrology
- Growth and Development
Background:
- Growth retardation is prevalent in 35-65% of pediatric kidney disease patients.
- Congenital, inherited, and acquired kidney diseases significantly impair growth.
- Reduced glomerular filtration rate (GFR) below 25 ml/min/1.73 m2 is a critical factor.
Purpose of the Study:
- To outline the multifaceted causes of growth failure in children with kidney disease.
- To identify key factors contributing to impaired growth in pediatric renal conditions.
Main Methods:
- Review of literature on growth in pediatric kidney disease.
- Analysis of factors associated with growth impairment in renal conditions.
Main Results:
- Prednisone therapy and chronic dialysis (hemodialysis, peritoneal) are linked to poor growth.
- Azotemia, acidosis, hyposthenuria, renal osteodystrophy, endocrine issues, and nutritional deficits contribute to growth failure.
Conclusions:
- Growth failure in pediatric kidney disease is multifactorial, involving disease type, severity, and treatment side effects.
- Addressing azotemia, acidosis, endocrine, and nutritional disturbances is crucial for improving growth outcomes.
Abstract:
Growth retardation occurs in 35 to 65% of children with kidney disease. It is especially common in children with congenital diseases of the kidney, anomalies, and inherited disorders. Acquired disease, however, also may impair growth, particularly where renal function (GFR) is below 25 ml/min/1.73 m2. Therapy used in renal disease, notably prednisone, also impairs growth. Chronic dialysis therapy, both hemodialysis and peritoneal, are associated with poor growth. Several specific changes in renal disease are associated with growth failure. These include, in addition to azotemia, acidosis, hyposthenuria, renal osteodystrophy, endocrine disorders and resistance to hormone action, and nutritional disturbances.