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Growth in children with various therapies for end-stage renal disease
Insights
Children on continuous ambulatory peritoneal dialysis (CAPD) showed better growth compared to hemodialysis and similar growth to kidney transplant recipients. CAPD also improved bone health and reduced acidosis in pediatric end-stage renal disease (ESRD) patients.
Area of Science:
- Pediatric Nephrology
- Renal Replacement Therapy
- Growth and Development
Background:
- End-stage renal disease (ESRD) significantly impacts growth in children.
- Continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis are common treatments.
- Kidney transplantation offers a potential solution for growth restoration.
Purpose of the Study:
- To compare the growth of children with ESRD on CAPD versus hemodialysis.
- To evaluate growth in CAPD patients against kidney transplant recipients.
- To assess the impact of CAPD on metabolic and bone health.
Main Methods:
- Comparison of growth velocities (actual vs. predicted bone age) across treatment groups.
- Assessment of acid-base balance and renal osteodystrophy.
- Analysis of caloric intake in CAPD and hemodialysis groups.
Main Results:
- Children on CAPD demonstrated superior growth compared to hemodialysis.
- Growth in CAPD patients was comparable to that of kidney transplant recipients.
- CAPD was associated with reduced acidosis and improved renal osteodystrophy.
- No significant difference in caloric intake was noted between CAPD and hemodialysis groups.
Conclusions:
- CAPD is an effective renal replacement therapy for promoting growth in children with ESRD.
- CAPD offers advantages over hemodialysis regarding metabolic and bone health.
- Growth outcomes in CAPD children are comparable to those post-kidney transplantation.
Abstract:
The growth of children undergoing continuous ambulatory peritoneal dialysis (CAPD) therapy for end-stage renal disease (ESRD) was compared with the growth of children undergoing hemodialysis and that of children after successful kidney transplantation. The bone ages of the children were used to predict expected growth velocities. The actual growth velocities observed were then expressed as percentages of the predicted rates. Children receiving CAPD therapy grew better than those treated by hemodialysis and as well as the children who received a kidney transplant. There was some correlation between growth and allograft function in the transplant recipients. Children receiving CAPD were less acidotic and were more likely to exhibit improvement in renal osteodystrophy than children treated by ongoing hemodialysis. There were no significant differences in reported caloric intake between the two groups.