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Growth in children with chronic kidney disease and associated risk factors for short stature
Virgínia Barbosa de Melo1, Danielle Barbosa da Silva1, Matheus Dantas Soeiro2
1Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil.
Insights
Children with chronic kidney disease (CKD) often experience short stature, especially younger patients. Monitoring growth, controlling hyperparathyroidism, and nutritional support are crucial for managing growth failure in pediatric CKD.
Area of Science:
- Pediatric Nephrology
- Growth and Development
- Chronic Kidney Disease Management
Background:
- Growth failure is a significant complication in children with chronic kidney disease (CKD), contributing to increased morbidity and mortality.
- Identifying modifiable risk factors is essential for improving care strategies for affected children.
Purpose of the Study:
- To investigate growth patterns in children with stages 3-5 CKD not on dialysis.
- To identify risk factors associated with short stature in this pediatric population.
Main Methods:
- Retrospective analysis of anthropometric and epidemiological data from 43 children with stages 3-5 CKD.
- Evaluation of biochemical markers including parathyroid hormone (PTH), calcium, and phosphate levels.
- Follow-up data collected for at least one year.
Main Results:
- 51% of children exhibited short stature, with younger children being more affected.
- Mean height/length/age z-scores were significantly lower at follow-up compared to baseline.
- Elevated PTH levels correlated with reduced height z-scores; younger children (<5 years) showed a higher prevalence of failure to thrive and poorer nutritional status (weight/age and BMI/age z-scores).
Conclusions:
- Pediatric patients with non-dialysis CKD have a high prevalence of short stature, particularly those who are younger.
- Parathyroid hormone levels are a significant factor influencing height z-scores.
- Effective management requires vigilant growth monitoring, control of hyperparathyroidism, and targeted nutritional support.
Introduction:
Growth failure in chronic kidney disease is related to high morbidity and mortality. Growth retardation in this disease is multifactorial. Knowing the modifiable factors and establishing strategies to improve care for affected children is paramount.
Objectives:
To describe growth patterns in children with chronic kidney disease and the risk factors associated with short stature.
Methods:
We retrospectively analyzed anthropometric and epidemiological data, birth weight, prematurity, and bicarbonate, hemoglobin, calcium, phosphate, alkaline phosphatase, and parathormone levels of children with stages 3-5 CKD not on dialysis, followed for at least one year.
Results:
We included 43 children, the majority of which were boys (65%). The mean height/length /age z-score of the children at the beginning and follow-up was -1.89 ± 1.84 and -2.4 ± 1.67, respectively (p = 0.011). Fifty-one percent of the children had short stature, and these children were younger than those with adequate stature (p = 0.027). PTH levels at the beginning of the follow-up correlated with height/length/age z-score. A sub-analysis with children under five (n = 17) showed that 10 (58.8%) of them failed to thrive and had a lower weight/age z-score (0.031) and lower BMI/age z-score (p = 0.047).
Conclusion:
Children, particularly younger ones, with chronic kidney disease who were not on dialysis had a high prevalence of short stature. PTH levels were correlated with height z-score, and growth failure was associated with worse nutritional status. Therefore, it is essential to monitor the growth of these children, control hyperparathyroidism, and provide nutritional support.
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