Chronic renal failure in infants: effect of strict conservative treatment on growth

Twenty infants with chronic renal failure from the first weeks of life, received strict conservative treatment consisting of a protein-restricted, calorie-enriched diet, supplements of essential amino acids, sodium chloride, sodium bicarbonate, calcium and vitamin D. The last 10 patients also received erythropoietin. Neither nasogastric nor gastrostomy tubes were used in any of these patients. Four patients needed dialysis in the second half of the 1st year of life. We analysed the patients' growth in weight, height and head circumference from birth until the age of 12 months. At the age of 12 months, mean values of height, weight and head circumference SDS were -1.63, -1.53 and -1.01 respectively as compared to healthy children. The body length data also compare favourably with those from a large cohort of chronic renal failure patients collected by the European Study Group for Nutritional Treatment of Chronic Renal Failure in Childhood; here the mean height SDS at 12 months of age is -3.3.

This retrospective analysis shows that the generally observed progressive growth retardation in infants with chronic renal failure can be prevented by early and adequate conservative management.