Growth in children with chronic kidney disease

a report from the Chronic Kidney Disease in Children Study

Nancy M. Rodig, Kelly C. McDermott, Michael F. Schneider, Hilary M. Hotchkiss, Ora Yadin, Mouin G. Seikaly, Susan L. Furth, Bradley A. Warady

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

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 m<sup>2</sup>) 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 (CO<inf>2</inf>) level of ≥22 mEq/L, children with CO<inf>2</inf> 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.

Original languageEnglish (US)
Pages (from-to)1987-1995
Number of pages9
JournalPediatric Nephrology
Volume29
Issue number10
DOIs
StatePublished - 2014

Fingerprint

Chronic Renal Insufficiency
Growth
Glomerular Filtration Rate
Growth Hormone
Weights and Measures
Human Growth Hormone
Clinical Laboratory Techniques
Population Growth
Bicarbonates
Acidosis
Body Mass Index
Confidence Intervals
Serum

Keywords

  • Children
  • Chronic kidney disease
  • Growth
  • Metabolic acidosis

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Rodig, N. M., McDermott, K. C., Schneider, M. F., Hotchkiss, H. M., Yadin, O., Seikaly, M. G., ... Warady, B. A. (2014). Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children Study. Pediatric Nephrology, 29(10), 1987-1995. https://doi.org/10.1007/s00467-014-2812-9

Growth in children with chronic kidney disease : a report from the Chronic Kidney Disease in Children Study. / Rodig, Nancy M.; McDermott, Kelly C.; Schneider, Michael F.; Hotchkiss, Hilary M.; Yadin, Ora; Seikaly, Mouin G.; Furth, Susan L.; Warady, Bradley A.

In: Pediatric Nephrology, Vol. 29, No. 10, 2014, p. 1987-1995.

Research output: Contribution to journalArticle

Rodig, NM, McDermott, KC, Schneider, MF, Hotchkiss, HM, Yadin, O, Seikaly, MG, Furth, SL & Warady, BA 2014, 'Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children Study', Pediatric Nephrology, vol. 29, no. 10, pp. 1987-1995. https://doi.org/10.1007/s00467-014-2812-9
Rodig, Nancy M. ; McDermott, Kelly C. ; Schneider, Michael F. ; Hotchkiss, Hilary M. ; Yadin, Ora ; Seikaly, Mouin G. ; Furth, Susan L. ; Warady, Bradley A. / Growth in children with chronic kidney disease : a report from the Chronic Kidney Disease in Children Study. In: Pediatric Nephrology. 2014 ; Vol. 29, No. 10. pp. 1987-1995.
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abstract = "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.",
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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.

PY - 2014

Y1 - 2014

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

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KW - Growth

KW - Metabolic acidosis

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