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Growth Failure Associated With Parathyroid Hormone Levels in Pediatric Dialysis Patients: A Nationwide Cohort Study

Takahiro Imaizumi1,2, Takuo Kubota3, Hirotaka Komaba4

  • 1Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan.

Kidney Medicine
|February 2, 2026
PubMed

Insights

Secondary hyperparathyroidism is linked to growth failure in children undergoing dialysis. Elevated parathyroid hormone (PTH) levels correlate with reduced height velocity and short stature in these patients.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth and Development

Background:

  • Growth failure is a significant concern in pediatric dialysis patients, potentially leading to lifelong growth retardation.
  • Secondary hyperparathyroidism is common in this population and may impact physical development.

Purpose of the Study:

  • To investigate the association between secondary hyperparathyroidism and short stature.
  • To examine the relationship between intact parathyroid hormone (PTH) levels and height growth failure in pediatric dialysis patients.

Main Methods:

  • A cohort study was conducted using data from a nationwide dialysis registry in Japan (2009-2020).
  • Participants included 622 patients aged 1-20 years initiating dialysis.
  • Intact PTH levels were analyzed against height standard deviation score (SDS), short stature, height velocity SDS, and height growth failure using cross-sectional and longitudinal analyses.

Main Results:

  • Nearly half of the patients (49%) presented with short stature at enrollment (height SDS ≤ -2.0).
  • A significant proportion (75%) experienced height growth failure (height velocity SDS ≤ -1.5) during the first year.
  • Elevated intact PTH levels were associated with decreased height velocity and increased odds of height growth failure.

Conclusions:

  • Secondary hyperparathyroidism appears to play a role in height growth failure among children on dialysis.
  • Findings highlight the importance of managing PTH levels to optimize growth in this vulnerable population.
Abstract

Keywords:
Pediatric patientschronic kidney disease-mineral and bone disorderdialysisgrowth failurelongitudinal growth

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