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Failure to thrive in children with tubulopathies

Giulio Rivetti1, Francesco Emma2, Faidra Veligratli3

  • 1Department of Woman, Child and of General and Specialized Surgery, Università Degli Studi Della Campania "Luigi Vanvitelli", Via Luigi De Crecchio 2, 80138, Naples, Italy.

Pediatric Nephrology (Berlin, Germany)
|November 20, 2025
PubMed

Insights

Failure to thrive (FTT) in children with kidney tubulopathies stems from impaired nutrient and electrolyte balance. This review covers how kidney dysfunction causes growth problems and how to manage these complex pediatric cases.

Area of Science:

  • Pediatric Nephrology
  • Growth Disorders
  • Renal Physiology

Background:

  • Failure to thrive (FTT) is a significant clinical issue in pediatric tubulopathies.
  • Kidney tubule dysfunction affects solute, electrolyte, and acid-base homeostasis.
  • These imbalances disrupt normal growth via renal and systemic pathways.

Purpose of the Study:

  • To review the current evidence on FTT in pediatric tubulopathies.
  • To elucidate the pathophysiological mechanisms linking tubulopathies to impaired growth.
  • To outline the clinical presentation and management strategies for FTT in this population.

Main Methods:

  • Literature review of pathophysiological mechanisms.
  • Analysis of clinical presentation data.
  • Summary of current management guidelines.

Main Results:

  • Defective tubular transport underlies FTT in pediatric tubulopathies.
  • Impaired handling of solutes, electrolytes, and acid-base balance are key contributors.
  • Both renal-specific and systemic effects impede growth.

Conclusions:

  • Understanding the pathophysiology of FTT in pediatric tubulopathies is crucial.
  • Early recognition of clinical signs aids timely intervention.
  • Comprehensive management strategies are essential for optimizing growth outcomes.

Keywords:
Bartter syndromeFailure to thriveFanconi syndromeNephrogenic diabetes insipidusRenal tubular acidosisTubulopathies

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