TY - JOUR
T1 - Growth in children with chronic kidney disease
T2 - a report from the Chronic Kidney Disease in Children Study
AU - Rodig, Nancy M.
AU - McDermott, Kelly C.
AU - Schneider, Michael F.
AU - Hotchkiss, Hilary M.
AU - Yadin, Ora
AU - Seikaly, Mouin G.
AU - Furth, Susan L.
AU - Warady, Bradley A.
N1 - Funding Information:
Data in this manuscript were collected by the Chronic Kidney Disease in children prospective cohort study (CKiD) with clinical coordinating centers (Principal Investigators) at Children’s Mercy Hospital and the University of Missouri–Kansas City (Bradley Warady, MD) and Children’s Hospital of Philadelphia (Susan Furth, MD, PhD), Central Biochemistry Laboratory (George Schwartz, MD) at the University of Rochester Medical Center, and data coordinating center (Alvaro Muñoz, PhD) at the Johns Hopkins Bloomberg School of Public Health. The CKiD Study is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute (U01-DK-66143, U01-DK-66174, U01DK-082194, U01-DK-66116). The CKID website is located at http://www.statepi.jhsph.edu/ckid .
Publisher Copyright:
© 2014, IPNA.
PY - 2014/10
Y1 - 2014/10
N2 - Background: Growth failure is common among children with chronic kidney disease (CKD). We examined the relationship of growth parameters with glomerular filtration rate (GFR), CKD diagnosis, sex and laboratory results in children with CKD.Methods: Baseline data from 799 children (median age 11.0 years, median GFR 49.9 mL/min/1.73 m2) participating in the Chronic Kidney Disease in Children Study were examined. Growth was quantified by age–sex-specific height, weight, body mass index (BMI–age), and height–age–sex-specific BMI (BMI-height-age) standard deviation scores (SDS).Results: Median height and weight SDS were −0.55 [interquartile range (IQR) −1.35 to 0.19] and 0.03 (IQR −0.82 to 0.97), respectively. Girls with non-glomerular CKD were the shortest (median height SDS −0.83; IQR −1.62 to −0.02). Compared to those with a serum bicarbonate (CO2) level of ≥22 mEq/L, children with CO2 of <18 mEq/L had a height SDS that was on average 0.67 lower [95 % confidence interval (CI) −0.31 to −1.03]. Only 23 % of children with a height SDS of ≤−1.88 were prescribed growth hormone therapy. Forty-six percent of children with glomerular CKD were overweight or obese (BMI-height-age ≥85th percentile).Conclusions: Growth outcomes in a contemporary cohort of children with CKD remain suboptimal. Interventions targeting metabolic acidosis and overcoming barriers to recombinant human growth hormone usage may improve growth in this population.
AB - Background: Growth failure is common among children with chronic kidney disease (CKD). We examined the relationship of growth parameters with glomerular filtration rate (GFR), CKD diagnosis, sex and laboratory results in children with CKD.Methods: Baseline data from 799 children (median age 11.0 years, median GFR 49.9 mL/min/1.73 m2) participating in the Chronic Kidney Disease in Children Study were examined. Growth was quantified by age–sex-specific height, weight, body mass index (BMI–age), and height–age–sex-specific BMI (BMI-height-age) standard deviation scores (SDS).Results: Median height and weight SDS were −0.55 [interquartile range (IQR) −1.35 to 0.19] and 0.03 (IQR −0.82 to 0.97), respectively. Girls with non-glomerular CKD were the shortest (median height SDS −0.83; IQR −1.62 to −0.02). Compared to those with a serum bicarbonate (CO2) level of ≥22 mEq/L, children with CO2 of <18 mEq/L had a height SDS that was on average 0.67 lower [95 % confidence interval (CI) −0.31 to −1.03]. Only 23 % of children with a height SDS of ≤−1.88 were prescribed growth hormone therapy. Forty-six percent of children with glomerular CKD were overweight or obese (BMI-height-age ≥85th percentile).Conclusions: Growth outcomes in a contemporary cohort of children with CKD remain suboptimal. Interventions targeting metabolic acidosis and overcoming barriers to recombinant human growth hormone usage may improve growth in this population.
KW - Children
KW - Chronic kidney disease
KW - Growth
KW - Metabolic acidosis
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U2 - 10.1007/s00467-014-2812-9
DO - 10.1007/s00467-014-2812-9
M3 - Article
C2 - 24728472
AN - SCOPUS:84939897530
SN - 0931-041X
VL - 29
SP - 1987
EP - 1995
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 10
ER -